Objective To test the levels of anti-double-stranded DNA (anti-dsDNA) antibody,Anti-nucleosome(AnuA) and Anti-dsDNA-NcX in serum of patients with systemic lupus erythematosus (SLE),analyze the sensitivity and specificity of anti-dsDNA,AnuA and Anti-dsDNA-NcX and the correlation between others laboratry indexs in SLE,to supply the evidence of diagnostics and treatment for SLE,for clinical practic of association detecting to make initial investigate.Methods ELISA were used to detect serum Anti-dsDNA Anti-nucleosome and Anti-dsDNA-NcX in 91 patients with SLE,as well as 45 disease controls and 46 heathy controls.We analysed sensitivity and specificity of three antibody,evaluated the correlation between others laboratory index.Results the positive rate of Anti-dsDNA,Anti-nucleo-some and Anti-dsDNA-NcX was 56.04％,49.45％ and 61.54％ respectively,Specificity was 94.51％,94.51％ and 100.00％ respectively.Anti-nucleosome,Anti-dsDNA and Anti-dsDNA-NcX were positively associated with SLEDAI (r =0.50,P =0.00 ; r =0.49,P =0.00 ; r =0.42,P =0.00).The titers of ANA was positively correlated with AnuA and Anti-dsDNA-NcX concentration (r =0.30,P =0.00;r =0.50,P =0.00),ANA titers was not correlation with Anti-dsDNA (r =0.19,P =0.08).There was no statistics difference of ESR among negative and positive grops of Anti-dsDNA and Anti-dsDNA-NcX (x2 =0.76,P =0.38 ;x2 =0.13,P =0.18),there was statistics difference between the negative with positive grops of AnuA (x2 =20.31,P =0.00).The difference of CRP and UPRO were not statistic significant in the three antibodies.complement 3 、complement 4 was statistic significant in the negative with positive groups of AnuA、Anti-dsDNA and Anti-dsDNA-NcX(x2 =9.84,P =0.00 ; x2 =16.53,P =0.00 ; x2 =10.33,P =0.00 ; x2 =11.61,P =0.00 ; x2 =12.69,P =0.00 ; x2 =8.77,P =0.00 respectively).There was no statistics difference of CysC among negative and positive groups of Anti-dsDNA and AnuA (x2 =0.76,P =0.38;x2 =0.13,P =0.18),there was statistics difference between the negative with positive groups of Anti-dsDNA-NcX(x2 =4.04,P =0.04).Conclusion Anti-dsDNA-NcX regarded as an important serologic marker in the diagnosis and determination of disease activity,and the sensitivity and specificity were higher than AnuA and Anti-dsDNA,three antibodies were associated with disease activity with SLE.It could help to evaluate the disease condition.%目的 通过检测系统性红斑狼疮(SLE)患者血清中抗核小体抗体(AnuA)、抗双链DNA (dsDNA)抗体和抗超敏双链DNA (dsDNA-NcX)抗体的水平,分析其在SLE患者中的敏感性、特异性及与其他实验室指标的相关性.方法 采用酶联免疫吸附试验(ELISA)法分别检测91例SLE患者、45例非SLE疾病对照和46例健康对照组血清中AnuA、抗dsDNA抗体和抗dsDNA-NcX抗体的水平,比较3种抗体对SLE诊断的敏感性和特异性,评价其与其他实验室指标的关系.结果 SLE患者AnuA、抗dsDNA抗体和抗dsDNA-NcX抗体的阳性率分别为49.45％、56.04％和61.54％；特异性分别为94.51％、94.51％和100.00％.AnuA、抗dsDNA抗体和抗dsDNA-NcX抗体均与SLEDAI评分呈正相关(r=0.50,P=0.00；r =0.49,P=0.00；r =0.42,P=0.00).ANA的滴度与AnuA的浓度呈正相关(r=0.30,P=0.00),与抗dsDNA抗体的滴度无相关性(r=0.19,P=0.08),与抗dsDNA-NcX抗体的浓度呈正相关(r=0.50,P=0.00).红细胞沉降率在抗dsDNA-NcX抗体、抗dsDNA抗体阴性和阳性组间比较差异无统计学意义(x2=0.76,P=0.38；x2=0.13,P=0.18),而在AnuA阴性与阳性组间比较差异有统计学意义(x2 =20.31,P=0.00).CRP及24小时尿蛋白定量在三者阴性与阳性组间比较差异无统计学意义.补体C3、C4在AnuA、抗dsDNA抗体和抗dsDNA-NcX抗体的阴性与阳性组间比较差异有统计学意义(x2=9.84,P=0.00;x2=16.53,P=0.00;x2 =10.33,P=0.00;x2 =11.61,P=0.00;x2 =12.69,P=0.00;x2=8.77,P=0.00).胱抑素在抗dsDNA抗体和AnuA的阴性与阳性组间比较差异无统计学意义,而在抗dsDNA-NcX抗体阴性与阳性组间比较差异有统计学意义(x2 =4.04,P=0.04).结论 抗dsDNA-NcX抗体可作为SLE的特异性抗体之一,其敏感性和特异性均高于抗dsDNA抗体和AnuA,三者均与SLE的疾病活动相关,联合检测有助于评估病情.
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