血清抗核小体抗体表达与系统性红斑狼疮疾病活动相关性评价

目的研究抗核小体抗体与系统性红斑狼疮(SLE)疾病活动的相关性、灵敏度、特异度等。方法收集SLE病例58例,按SLE疾病活动指数分为非活动组、轻度、中度、重度活动组,同时设对照组25例。采用间接免疫荧光法、免疫印迹法、速率散射比浊法、全自动血沉分析仪等分别检测抗核心抗体(ANA)、抗核小体抗体、抗-ds-DNA、抗-Sm、C3、红细胞沉降率(ESR)。结果 (1)抗核小体抗体阳性检出率与SLE疾病活动程度呈正相关(r=0.638,χ2=40.235,P=0.00)。(2)抗核小体抗体对SLE疾病诊断的灵敏度(51.72%)高于抗-ds-DNA(20.69%)和抗-Sm(41.38%),其特异度(92%)也与抗-ds-DNA(96%)和抗-Sm(92%)接近。(3)SLE患者血清抗核小体抗体表达水平与C3呈负相关(r=-0.595,P=0.00),与ESR呈正相关(r=-0.783,P=0.00),而与ANA核型、滴度水平无明显相关性(P>0.05)。结论抗核小体抗体检测作为一项新的与SLE疾病活动密切相关、灵敏度高、特异性强且操作简便的实验室评价指标,将在SLE疾病诊断、合理治疗及疗效评估方面发挥重要价值。

Evaluation on correlation between serum anti-nucleosome antibody and activity of systemic lupus erythematosus

Objective To study the correlation between anti-nucleosome antibody（ANuA） and the activity of systemic lupus erythematosus（SLE） ,and the sensitivity and specificity of ANuA in SLE diagnosis. Methods 58 SLE patients were collected and divided into three groups according to SLE disease activity index（DAI）,inactive group, mild activity group, moderate and severe activity group. Other 25 cases including other rheumatic diseases and health subjects were collected as the control group. Then ANA, ANuA, ds-DNA antibody, anti-Sin,C3 and ESR were detec- ted by using indirect immunefluorescence, Western blotting, rate nephelometry assay and automatic ESR analyzers, etc. Results （1） The positive rate of ANuA was positively correlated with the disease activity level of SLE（r= 0. 638,X^2 =40. 235,P：0.00）. （2） The sensitivity of ANuA in diagnosing SLE was 51.72% ,which was higher than 20.69% of ds-DNA antibody and 41.38% of anti-Sin,the specificity of ANuA was 92% ,which was close to 96% of ds-DNA antibody and 92% of anti-Sm. 3. The ANuA expression level in SLE＇ s serum was negatively correlated with C3 （r= - 0. 595, P = 0.00）, and positively correlated with ESR（r=- 0. 783, P = 0.00）, but had no significant corre- lation with ANA karyotype and titer（P〉0.05）. Conclusion The ANuA detection is regarded as a new laboratory e- valuation index with the close correlation with SLE activity,high sensitivity and strong specificity in diagnosing SLE, and is easy to operate, which will play an important role in SLE diagnosis, rational therapy and curative effects assess-ment.