系统性红斑狼疮抗核抗体及其变化的临床意义

目的探讨抗核抗体及其变化在系统性红斑狼疮（SLE）的临床意义。方法对50例SLE患者的实验室及临床资料进行回顾性分析。结果IFANA、抗ds—DNA、抗Sm、抗U1-RNP、抗SS—A、抗SS—B抗体的阳性率分别为100％、70％、30％、44％、52％、22％。IFANA的滴度高低与病情活动状况无关，转阴并不表示病情缓解；抗ds—DNA抗体与狼疮性肾炎相关，持续高滴度常表示疾病活动特别是狼疮肾活动；抗SM抗体与病情无关，治疗后易消失；抗U1-RNP抗体与雷诺氏现象相关；抗SS—A抗体与光敏感相关；抗SS—B抗体与干燥综合征相关。抗U1-RNP抗体、抗SS—A抗体及抗SS—B抗体这3种抗体多持续存在。结论在SLE，各种ANA可能代表不同的亚型。

Clinical significance of antinuclear antibody and its changes in 50 systemic lupus erythematosus patients

Objective To study the clinical significance of ANA and it's change in SLE. Methods Fifty patients with SLE from 1986-1991 were reviewed. Results IFANA was positive in 100% of patients, anti-ds DNA in 70%, anti-Sm in 30%, anti-UIRNR in 44%, anti-SSA in 52%, and anti-SSB in 22%. IFANA titers did not correlate with the activity of disease and its change from positive to negative did not predict remission Anti-dsDNA was associatied with lupus nephritis and its sustained high-titer indicted activity of disease, especially of renal disease. Anti-Sm did not correlate with disease activity and might disappear after treatment. Anti-UIRNP was correlated with Raynaud's phinomenon, anti-SSA with photosensitivity, and anti-SSB with Sjog-ren's syndrome. Usually the latter three antibodies did not disappear. Conclusion In patients with SLE, various ANAs may represent different subtypes.