免疫金银染色法检测SLE患者血清抗核抗体和抗双链DNA抗体的临床研究

目的　探讨检测系统性红斑狼疮 (SLE)患者血清抗核抗体 (ANA)和抗双链DNA抗体 (A -dsDNA)的临床意义。方法　用免疫金银染色法 (immunogold -silverstaining ,IGSS)和斑点免疫金银染色法 (dot -immunogold -silverstaining ,Dot-IGSS)同步检测SLE患者血清ANA和A -dsDNA。结果　 16 9例活动期SLE患者血清ANA和A -dsDNA的阳性率分别为 98.2 %和 77.2 % ;4 4例非活动期患者ANA和A -dsDNA的阳性率分别为 72 .2 %和15 .9% ,两组比较 ,阳性率有显著性差异 (P <0 .0 1)。活动期病人的血清滴度也较非活动期患者高 (P <0 .0 1) ;A -dsDNA阳性患者的肾损害率明显高于A -dsDNA阴性者 (P <0 .0 1)。结论　ANA、A -dsDNA阳性且滴度高提示SLE处于活动期 ,A -dsDNA阳性提示有肾损害的可能 ;但A -dsDNA阴性亦不能排除SLE。

Clinical significance of serum ANA and A-dsDNA in SLE patients assessed by Immunogold-silver Staining

Objective To investigate the clinical significance in detecting the anti-nuclear antibody (ANA) and anti-double stranded DNA (A-dsDNA) in the sera of patients with SLE. Methods The ANA and A-dsDNA antibodies in the sera of SLE patients were detected by immunogold-silver staining (IGSS) and Dot-IGSS. Results The positive rates of ANA and A-dsDNA were 98.2% and 77.2% respectively in 169 patients with active SLE, and 72.2% and 15.9% respectively in 44 inactive cases. The positive rates of ANA and A-dsDNA were significantly higher in the active cases than in the inactive cases, and as well were the titers of ANA (P<0.01). The incidence of renal involvement was higher in the A-dsDNA positive cases than in the negative ones (64.3% vs. 31.0%, P<0.01), but the incidence was not related to the positive rate of ANA (P>0.05). Conclusion Higher titers of ANA and A-dsDNA suggest the SLE patients be in active stage, positive A-dsDNA indicats a likelihood of renal damage, but negative reaction to A-dsDNA does not rule out SLE.