几种免疫学指标联合检测对系统性红斑狼疮的诊断价值

目的探讨IgG、IgA、IgM、C3、C4、抗核抗体谱(ANAS),抗双链脱氧核糖(ds-DNA)抗体,可提取核抗原(ENA)的联合检测在系统性红斑狼疮(SLE)临床诊断的应用价值。方法ANAS、抗ds-DNA及ENA的测定分别采用间接免疫荧光法、抗胶体金斑点渗滤法及免疫印记技术,对SLE活动组51例、非活动组64例患者的血清与45例健康对照组进行对比检测。结果SLE活动期患者IgG、IgA、IgM较对照组明显升高,C3、C4明显下降,差异有显著性(P值均<0·001);非活动期IgG、IgA较对照组高,差异有显著性(P<0·001和P<0·05),而C3、C4无明显差别(P>0·05)。115例SLE患者的ANAS、抗ds-DNA抗体、ENA多肽抗体中的Sm阳性率分别为78·1%、62·3%及27·2%,而抗核糖核酸抗体u1RNP、抗SS-A、抗SS-B阳性率分别为36·0%、36·8%及16·6%,45例健康对照组均为阴性,差异有显著性(P值均<0·001)。结论多种血清学指标联合检测有助于对SLE的诊断和对病情活动程度进行检测。

The value of determination of several immunological indexes in the diagnosis of systemic lupus erythematosus

Objective To study the clinical value of combined examination of ANAS,dsDNA and ENA in the diagnosis of systemic lupus erytheratosus (SLE). Methods ANAS,dsDNA and ENA were examined in the sera samples from 51 active SLE and 64 inactive SLE and the results were compared with 45 healthy controls. Results Titers of IgG,IgM and IgA of active patients were higher than those of control group C3 and C4 levels of active patients were higher than those of control;the differences were statistically significant(P<0.001).IgG,IgM and IgA of active patients were higher than those of control,the difference were also statistically significant(P<0.001,P<0.05);C3,C4 and C5 levels did not differ between the two groups.The positive rates of ANAS,dsDNA,Sm,u1RNP,anti-ss-A,anti -ss-B were 71.8%,62.3%,27.2%,36.0%,36.8% and 16.6%,respective in 1/4 SLE patients,and all indexes were negative in 45 healthy controls,and the difference were statistically significant. Conclusion Combined Examination of various serologic indexes could help to Diagnosis SLE and to assess the degree of activity of the disease.