系统性红斑狼疮患者中检测ANCA临床意义的研究

目的探讨抗中性粒细胞胞浆抗体（ANcA）在系统性红斑狼疮（SLE）患者中检测的临床意义。方法通过间接免疫荧光法和免疫印迹法分别检测了25例健康对照组和106例SLE患者血清中的ANCA、抗核抗体（ANA）、抗双链DNA抗体、抗-SmDI抗体。结果对照组测定均为阴性。SLE患者中ANCA阳性率为47．2％（50／106），且均为环细胞核着色的核周型（pANCA）；在ANCA阳性组及ANCA阴性组中：ANA及抗-SmDl抗体阳性率分别为100％（50／50）、91．1％（51／56）：829／0（41／50）、67．9％（38／56），P均〉0．05；抗ds—DNA抗体阳性率分别为94％（47／50）、50％（Z8／56），P〈0．01。在活动性sLE（52例）和非活动性sLE（54例）中ANCA阳性率分别为84．6％（44／52）；11．1％（6／54），P〈O．01。结论ANCA在sLE患者中检测与ANA及抗-SmD1抗体没有相关性，与抗ds—DNA抗体正相关，活动期SLE患者中ANCA阳性率明显高于非活动期的患者。

The clinical significance of ANCA detction in patients with systemic lupus erythematosus

Objective To study the diagnostic value of anti-neutrophil cytoplasmic antibody (ANCA) detction in patients with systemic lupus erythematosus (SLE). Methods Indirect immunofluorescence (IIF) and Western blotting were applied to detecting the expression of sera ANCA, antinuclear antibody (ANA), anti-double-stranded DNA antibody, anti-SmithD1 antibody in 25 samples of control group and 106 samples of patients with SLE. Results ALL samples of control group showed negative; 47.2% (50/106) sera showed ANCA positive in patients with SLE,and all of them were peripheral nuclear pattern (pANCA). In ANCA positive group, the positive rate of ANA, anti-SmithD1 antibody and anti-ds-DNA antibody was respectively 100% (50/50), 82% (41/50) and 94% (47/50); in ANCA negative group, the positive rate was respectively 91.1% (51/56), 67.9% (38/56)and 50% (28/56). There were no statistical differences in positive rates of ANA and anti-SmithD1 antibody between ANCA positive and negative groups (both P＞0. 05), but there was in positive rates of anti-ds-DNA antibody (P＜0.01). ANCA positive rate was respectively 84.6% (44/52) and 11.1%(6/54) in active SLE group (n=52) and inactive SLE group (n=54) (P＜0.01). Conclusion The determined ANCA in patients with SLE is not correlative with ANA and anti-SmithD1 antibody, but positively relates to anti-double-stranded DNA antibody. The positive rate of ANCA in patients with active lupus is significantly higher than that in non-active lupus.