抗核小体抗体检测在系统性红斑狼疮中的临床价值

目的评价抗核小体抗体（ANuA）对系统性红斑狼疮（SLE）的诊断价值。方法检测216例SLE患者和150例非SLE风湿病患者的血清ANuA、抗双链DNA（ds—DNA）抗体、C3、C4、血沉（ESR）水平，评估SLE患者24小时尿蛋白定量及病情活动程度。利用ROC曲线、四格表、多因素秩和检验、多因素相关分析评价ANuA对SLE的诊断价值。结果ANuA诊断SLE的灵敏度和特异度分别为57．4％和98．0％。SLE活动组的ANuA水平明显高于SLE稳定组和非SLE风湿病组；肾脏受累的SLE患者体内的ANuA水平明显高于无肾脏受累者及非SLE风湿病组。ANuA与抗ds—DNA抗体、SLEDAI评分呈正相关，与补体C3、C4呈负相关。结论ANuA对于SLE的诊断价值与抗ds—DNA抗体相似；在中低度活动的SLE患者中其诊断价值明显高于抗ds—DNA抗体；在抗ds—DNA抗体阴性的情况下，ANuA水平的升高有助于SLE诊断的确立；SLE患者体内ANuA水平可作为判断病情活动的指标之一。

The diagnostic value of anti-nucleosome antibody in patients of systemic lupus erythematosus

Objective To assess the diagnostic value of anti-nucleosome antibody （ANuA） for SLE. Methods The levels of ANuA and ds-DNA,C3 ,C4 and ESR were detected in serum samples of 216 SLE patients, 150 non-SLE patients with various rheumatic diseases, 24 hour-urine protein and SLEDAI score listes were collected in all SLE patients. The diagnostic value of ANuA was tested with Chi-square test, multiple factors rank term test and multiple factors correlation analysis. Result The sensitivity of ANuA was 57.4% and the specificity was 98.0%. The levels of ANuA in active SLE patients were higher than inactive SLE patients and non-SLE patients;the levels of ANuA were also higher in SLE patients with renal damage. ANuA showed positive correlation with the quantity of ds-DNA,SLEDAI scores,negative correlation with C3 , C4. Conclusion The diagnostic value of ANuA was a similar to ds-DNA antibody ; but higher than ds-DNA antibody in stable patients. So in early stage,when the ds-DNA antibody was negative the level of ANuA was a good reference for diagnosis;and it was an excellent marker for disease activity.