自身抗体检测在壮族人群系统性红斑狼疮诊断及病情发展中的意义

目的探讨自身抗体在壮族人群系统性红斑狼疮(SLE)诊断和病情发展中的意义。方法选取壮族SLE患者180例,疾病对照120例和健康对照120例,分别检测血清中抗核抗体(ANA)、抗中性粒细胞胞浆抗体(ANCA)、抗ENA抗体谱、抗C1q抗体、抗ds DNA抗体和抗心磷脂抗体(ACA),并探讨这些抗体与壮族SLE患者诊断、活动性、临床特征及实验室指标的关系。结果SLE组抗C1q、dsDNA、AnuA、ARPA、AHA、Sm、nRNP、ANCA、ACA抗体阳性率明显高于各对照组(P<0.01)。抗ds DNA、Sm抗体诊断特异性>90%。活动组抗C1q、dsDNA抗体水平及AnuA、ARPA、AHA、ANCA、ACA阳性率均高于非活动组(P<0.01)。这些抗体与肾脏损害、关节炎、24 h尿蛋白升高、白细胞减少、血红蛋白减少、血沉加快、补体C3/C4降低相关。结论抗C1q、dsDNA、AnuA、ARPA、AHA、Sm、nRNP、ANCA、ACA抗体是壮族人群SLE诊断的重要指标,与疾病活动及病情发展相关,在壮族人群SLE发病及病理过程中发挥极其重要的作用。

Significance of autoantibody detection in the diagnosis and development of systemic lupus erythematosus in the Zhuang Population

Objective To explore the clinical significance of autoantibodies in the diagnosis and the progression of disease in patients with systemiclupus erythematosus(SLE)in a Zhuang Population.Methods A total of 180 SLE patients,120 disease controls and 120 healthy individuals were involved in the study.ANA,ANCA,ENA profile,anti-C1 q,dsDNA,ACA antibodies were examined.The associations between the antibodies and the diagnosis of SLE,disease activity,clinical features,laboratory parameters were explored.Results The positive rate of anti-C1 q,dsDNA,AnuA,ARPA,AHA,Sm,nRNP,ANCA,ACA antibodies were significantly higher in SLE group than those in disease controls and healthy controls(P<0.01).The specificities of anti-ds DNA,Sm antibodies were more than 90%.The level of anti-C1 q,dsDNA and the positive rate of AnuA,ARPA,AHA,ANCA,ACA antibodies were significantly higher in active group than inactive group(P<0.01).These autoantibidies were correlated with kidney damage,arthritis,elevated 24 h urine protein,leukopenia,hemolyticanemia,elevated ESR,and decreased C3/C4.Conclusion Anti-C1 q,dsDNA,AnuA,ARPA,AHA,Sm,nRNP,ANCA,ACA were the main indicators for the diagnosis of SLE in a Zhuang Population.These antibodies appeared to be associated with disease activity and disease progression,suggesting their important roles in the pathological processes of SLE in a Zhuang Population.