系统性红斑狼疮患者血清抗核小体抗体水平检测及其临床意义

目的探讨抗核小体抗体(AnuA)水平与红斑狼疮(LE)疾病亚型及其治疗前后的关系。方法采用酶联免疫吸附法(ELISA)测定31例系统性红斑狼疮(SLE)、26例亚急性皮肤型红斑狼疮(SCLE)、7例盘状红斑狼疮(DLE)、6例硬皮病、5例皮肌炎患者和30例健康人血清AnuA水平,根据SLE患者临床表现及实验室检查指标,进行SLE疾病活动指数(SLEDAI)评分,并对LE患者AnuA进行治疗前后的比较。结果SLE患者血清AnuA水平与SCLE、DLE、硬皮病、皮肌炎患者和正常对照组相比显著增高(P均<0.01);SLE活动期患者血清AnuA水平与SLE非活动期相比显著增高(P均<0.01);SCLE、DLE、硬皮病患者血清AnuA水平两两相比差异无统计学意义(P>0.05),与皮肌炎、正常对照组相比差异有统计学意义(P<0.05);皮肌炎患者和正常人对照组相比差异无统计学意义(P>0.05)。AnuA水平与SLEDAI有明显相关性(P=0.015,r=0.441),SLE患者治疗后血清AnuA水平与治疗前相比明显降低(P<0.05)。结论AnuA水平与LE的亚型和是否活动有相关性,对诊断疾病、监测病情活动和判断疗效有意义。

Clinical Significance of Antinucleosome antibody in systemic lupus erythematosus

Objective To investigate the clinical significance of antinucleosome antibody (AnuA) in the patients with lupus erythematosus (LE) through detecting the serum level of AnuA in different types of LE patients before and after treatment. Methods Enzyme-linked immunosorbent assay(ELISA) was used to detect the serum level of AnuA in 31 SLE patients, 26 SCLE patients, 7 DLE patients, 6 scleroderma patients, 5 dermatomyositis patients and 30 healthy controls. Among them, the serum levels of AnuA before and after treatment were detected in 15 SLE patients and 10 SCLE patients. Clinical data, laboratory test results and the scores of SLE disease activity index (SLEDAI) were analyzed with SPSS11.0 software. Results The serum levels of AnuA in SLE patients were higher than those in SCLE, DLE, scleroderma, dermatomyositis patients and healthy controls(P < 0.01). The serum levels of AnuA in active SLE patients were higher than that in inactive SLE patients(P < 0.01), with a positive correlation with SLEDAI(P < 0.05,r = 0.441). The serum levels of AnuA in SLE patients decreased after treatment(P < 0.01). The serum levels of AnuA in SCLE, DLE and scleroderma patients were higher than those in dermatomyositis patients and healthy controls(P < 0.01). Conclusions The serum level of antinucleosome antibody is high in the patients with active SLE, which may be a useful parameter for the diagnosis and the assessment of disease activity in SLE.