系统性红斑狼疮患者活动期血清中的抗核抗体不同模式表达的探究

摘要

Objective To explore the reason why patients with systemic lupus erythematosus(SLE) in activity have different expression of antinuclear antibody(ANA) in the serum. To improve the accuracy of diagnosis in SLE disease and make a correct evaluation of the clinical value of diagnosis, treatment and prognosis of SLE. Methods Use the indirect fluorescent immunoassay (IIF) to detect ANA antibody in active SLE patients serum. And use the short film worm IIF method to detect anti dsDNA antibodies. Finally observed the different patterns fluorescence model of ANA under the fluorescence microscope. Results When the anti dsDNA drop degree is 1∶32, the homogeneous type is 76.6%, the particle type is 19.1%, and the nucleolus cytoplasm type is 4.3%. When the anti dsDNA drop degree is 1∶10, the homogeneous type is 54.8%, the particle type is 34.4%, the nucleoli and cytoplasm type is 6.5%and 4.63%respectively. Analyze the express correlation of Anti dsDNA drops down dsDNA and different expression of antinuclear antibody (ANA) with chi-square, the difference was statistically significant(P<0.05). Conclusion When the anti dsDNA was higher in 1∶32 before treatment, patients of SLE in active stage the karyotypes were not all expressed as homogeneous type ,and other low positive rates were also occur. And when the anti dsDNA titer decreased after the treatment , some of SLE′s own antibodies are not proportional to the disease activity. It will be expressed as the original other antibody titer , so the positive rate of homogeneous types were decreased, and the positive rate of other fluorescent karyotypse were elevated.%目的：探讨系统性红斑狼疮（SLE）患者活动期血清中的抗核抗体（ANA）不同模式表达的原因，提高SLE疾病诊断的准确性，对SLE诊断、治疗以及预后的临床价值做出正确的评价。方法使用间接荧光免疫法（IIF），对SLE活动期患者的血清进行ANA抗体检测；使用短膜虫IIF法检测抗dsDNA抗体，最后在荧光显微镜下观察不同模式的特异性荧光模型。结果抗dsDNA滴度为1∶32时均质型占76.6%，颗粒型19.1%，核仁胞质型4.3%；抗dsDNA抗体滴度为1∶10时，均质型占54.8%，颗粒型34.4%，核仁和胞质型分别占6.5%和4.63%。健康对照组各核型均为阴性。用字2检验对抗dsDNA抗体滴度下降与ANA不同核型模式表达相关性进行分析，差异有统计学意义（P＜0.05）。结论 SLE活动期患者中，治疗前抗dsDNA抗体为较高滴度如1∶32时，其核型不全都表达为均质型，也会出现其他低阳性率的核型。而当其治疗后抗dsDNA抗体滴度下降时，部分患者均值型核型消失，SLE患者体内的某些与疾病活动度不成正比的自身抗体会表现为原本的其他抗体滴度核型，从而出现均质型阳性率降低，而其他抗体荧光核型的阳性率升高的现象，这种变化对于SLE的治疗及预后起到积极作用。