联合检测抗核小体抗体和抗dsDNA抗体对SLE疾病活动和脏器损害的意义

目的探讨联合检测抗核小体抗体(AnuA)、抗dsDNA抗体对系统性红斑狼疮(SLE)疾病活动和脏器损害的意义。方法69例SLE分为疾病活动和疾病稳定组、狼疮肾炎(LN)和非狼疮肾炎组(NLN)。测定AnuA和抗dsDNA抗体水平,比较组间抗体水平差异,分析其与免疫指标的相关性。结果AnuA和抗dsDNA抗体阳性率为55.1%和47.82%,疾病活动组显著高于疾病稳定组(P<0.001)。抗dsDNA抗体阴性SLE中有16.6%AnuA阳性。两抗体与SLE疾病活动指数(SLEDAI)、IgG、球蛋白水平显著正相关,与C3、C4、白蛋白水平显著负相关。LN组两抗体水平均显著高于NLN。结论AnuA和抗dsDNA抗体都是SLE疾病活动指标,与LN相关,AnuA检测是对抗dsDNA抗体的有益补充。

Significance of combination of serum anti-nucleosome and anti-dsDNA antibodies in patients with systemic lupus erythematosus

Objective To explore the significance of antinucleosome and anti-dsDNA antibodies on the disease flare and organ damage in patients with systemic lupus erythematosus(SLE).Methods Sixty-nine SLE patients were divided into disease flare group,stable group,lupus nephritis group and non-lupus nephritis group.Serum levels of anti-nucleosome antibody and anti-dsDNA antibody were measured with enzyme linked immunosorbent assay(ELISA) and indirect immunofluorescence(IIF),respectively.Results The positive rates of serum anti-nucleosome and anti-dsDNA antibodies were 55.10% and 47.82% respectively and the rates were significantly higher in disease flare group than those in disease stable group(P<0.001).The positive rate of anti-nucleosome antibody may be positive in 16.6% anti-dsDNA negative patients.The levels of anti-nucleosome and anti-dsDNA antibodies were positively correlated with SLEDAI,IgG and globulin and negatively with the levels of C3,C4 and albumin.Serum levels of anti-nuclesome and anti-dsDNA antibodies were higher in lupus nephritis group than those in non-lupus nephritis group.Conclusion The levels of anti-nucleosome and anti-dsDNA antibodies are index of disease activity and correlated with lupus nephritis.The detection of anti-nucleosome antibody is helpful for the diagnose of SLE patients with negative anti-dsDNA.