两种检测抗双链 DNA 抗体方法的比较及分析

摘要

目的：探讨绿荧短膜虫间接免疫荧光(CL-IIF)法和酶联免疫吸附试验(ELISA)法检测抗双链 DNA(dsDNA)抗体的特点及临床应用价值。方法采用 CL-IIF 法和 ELISA 法同时检测85例系统性红斑狼疮(SLE)患者,20例疾病对照和75例健康体检者血清中抗 dsDNA 抗体,评价两种检测方法的诊断效能。结果两种方法在 SLE 组患者的阳性率明显高于疾病对照组及健康对照组,差异有统计学意义(P <0.05)。CL-IIF 法和 ELISA 法在 SLE 组的阳性率分别为72.94%和88.24%,后者的阳性预测值低于前者。同时 ELISA 法检测出 SLE 组、疾病对照组、健康对照组三组的抗 dsDNA 抗体浓度均数差异有统计学意义(P <0.05),各组抗 dsDNA 抗体的浓度均数间呈线性趋势(P <0.05)。结论CL-IIF 法检测 SLE 组的抗 dsDNA 抗体具有很高的特异性,有助于 SLE 的确诊。ELISA 法可定量检测抗 dsDNA 抗体的浓度,其浓度与 SLE 疾病活动度呈线性相关,且方法敏感性高,可有效筛查 SLE 患者。%Objective To investigate the characteristics and clinical application value of anti-double stranded DNA antibody de-tected by Crithidia indirect immunofluorescence assay method and enzyme linked immunosorbent assay method.Methods Eighty-five patients with systemic lupus erythematosus,20 disease controls and 75 healthy controls were selected.The serum anti-double stranded DNA antibody was detected simultaneously by the methods of Crithidia indirect immunofluorescence assay and enzyme linked immunosorbent assay and their diagnostic efficacies for detection were compared.Results For each method the positive rate in the systemic lupus erythematosus group was significantly higher than that in the disease control group and healthy control group. The difference had statistical significance (P <0.05).The positive rates of Crithidia indirect immunofluorescence assay and enzyme linked immunosorbent assay in the systemic lupus erythematosus group were 72.94% and 88.24% respectively,and the positive predictive value of enzyme linked immunosorbent assay is lower(P <0.05).Meanwhile the anti-double stranded DNA antibody con-centrations detected by enzyme linked immunosorbent assay method showed statistically significant difference among the active sys-temic lupus erythematosus group,the stable systemic lupus erythematosus group and the control group (P <0.05 )and presented linear trend.Conclusion Using Crithidia indirect immunofluorescence assay method to detect anti-double stranded DNA antibody for the systemic lupus erythematosus group has high specificity and is helpful for the diagnosis of systemic lupus erythematosus. Enzyme linked immunosorbent assay can be used to detect anti-double stranded DNA antibody concentration quantitatively,which is linearly related with systemic lupus erythematosus activity and the method is of high sensitivity,which can effectively screen the pa-tients with systemic lupus erythematosus.