Objective To evaluate the diagnostic value of anti-nucleosome antibodies( ANuA)in systemic lupus erythematosus (SLE). Methods The ELISA was used to measure the ANuA in 184 patients with systemic lupus erythematosus(SLE group) ,162 patients with other rheumatic diseases group and 98 control group were recruited to the study. Meanwhile ANA,anti-ds-DNA antibody and anti-Sm antibody were detected and analyzed. Results Seropositive for ANuA were 73. 9% in SLE group and 8. 6% in other rheumatic diseases group, seronegative for ANuA in control group. The sensitivity and specificity of ANuA in SLE were 73. 9% and 90. 67%respectively. There was statistical difference of sensitivity between ANuA and anti-ds-DNA antibody,anti-Sm antibody. The specificity of ANuA in SLE was higher than ANA(P<0. 05). The sensitivity of combination of ANuA and anti-ds-DNA antibody and anti-Sm antibody was 91. 3%. The incidences of ANuA in SLE with negative anti-ds-DNA antibody,anti-Sm antibody and ANA were 56. 7% ,75. 0% ,80. 8%. In addition seropositive for ANuA in active stage was significantly higher than that in non-active stage. The seropositive for ANuA in active stage(90.0%) was higher than anti-ds-DNA antibody(61. 3%). SLE patients with renal involvement in ANuA,anti-DNA antibody levels wre significantly higher than those in non renal in volvement(P< 0. 05). Conclusion There are important clinical significance on ANuA to improve diagnostic rate,judgement and evaluation of SLE.%目的 探讨抗核小体抗体(ANuA)对系统性红斑狼疮(SLE)的临床诊断价值及其与SLE活动性的关系.方法 选取该院SLE患者184例(SLE组),其他风湿病组162例,对照组98例.用ELISA法检测血清ANuA水平,同时检测抗核抗体(ANA)、抗双链DNA(ds-DNA)抗体、抗Sm抗体3项实验室指标.结果 SLE组血清ANuA阳性率为73.9%,其他风湿病组为8.6%,对照组全部为阴性;ANuA对SLE诊断的敏感度和特异度分别为73.9%、90.67%,其敏感度与抗ds-DNA抗体、抗Sm抗体比较差异有统计学意义(P<0.05);其特异度明显高于ANA(P<0.05).ANuA、抗ds-DNA和抗Sm抗体联合测定的敏感度为91.3%.在抗ds-DNA抗体、抗Sm抗体、ANA阴性的SLE患者中,ANuA阳性率分别为56.7%、75.0%、80.8%.活动期ANuA阳性率明显高于非活动期,ANuA在活动期的阳性率(90.0%)高于抗ds-DNA(61.3%).SLE肾脏受累患者体内的ANuA、抗ds-DNA抗体水平明显高于肾脏非受累者(P<0.05).结论 测定ANuA对于提高SLE的诊断率、判断病情和评价疗效有重要的临床意义.
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