抗核抗体谱、补体和免疫球蛋白检测对系统性红斑狼疮的诊断意义

摘要

目的 探讨抗核抗体谱(ANAs)、补体(C3、C4)和免疫球蛋白(IgG、IgM、IgA)在系统性红斑狼疮(SLE)诊断中的临床价值.方法 收集131例SLE患者作为SLE组,59例其他自身免疫疾病(AID)患者为疾病对照组(AID组),60例健康体检者为健康对照组.采用间接免疫荧光法(IIF)检测抗核抗体(ANA),线性免疫印迹法检测ANAs,速率散射法检测补体和免疫球蛋白.比较各指标的阳性率,选择SLE组阳性率较高的指标进行联合检测分析.结果 SLE组ANA、抗RNP/Sm抗体、抗Sm抗体、抗Ro-52抗体、抗SSA抗体、抗ds-DN A抗体、抗核小体抗体、抗核糖体 P 蛋白(Rib-P)抗体、C3、C4指标阳性率分别为97.71%、47.33%、22.90%、59.54%、57.25%、21.37%、19.08%、32.82%、53.44%、64.12%,与AID组和健康对照组差异均有统计学意义(P<0.05).将抗dsDNA 抗体和抗Sm抗体分别与抗Ro-52抗体、抗SSA 抗体、抗核小体抗体、抗Rib-P抗体、补体(C3、C4)联合检测,各联合模式阳性率均高于 AID组(P<0.05),并且与抗Ro-52抗体、抗SSA抗体、抗Rib-P抗体、补体(C3、C4)联合的检测模式阳性率也高于抗dsDNA抗体和抗Sm抗体的二联模式(P<0.05).结论 抗Sm抗体、抗Ro-52抗体、抗SSA抗体、抗dsDNA 抗体、抗核小体抗体、抗Rib-P抗体以及补体(C3、C4)等指标对SLE诊断具有重要意义,并且联合诊断能提高SLE诊断的灵敏度,具有重要的临床价值.%Objective To explore the application value of antinuclear antibody spectrum(ANAs),comple-ment(C3、C4)and immunoglobulin(IgG,IgM,IgA)in diagnosis of systemic lupus erythematosus(SLE).Meth-ods A total of 131 patients of SLE were collected in the experimental group,and 59 cases of other autoim-mune disease(AID)and 60 healthy persons in the control groups.The antinuclear antibody(ANA)was tested by indirect immunofluorescence(IIF)method,the antinuclear antibody spectrum was tested by the linear west-ern blot method,and serum complement and immunoglobulin levels was measured by rate nephelometry assay. The better markers for combined detection of SLE were selected.Results The positive rates of the antibodies against ANA,RNP/Sm,Sm,Ro-52,SSA,dsDNA,Nucleosome,Rib-P,C3 and C4 were 97.71%,47.33%, 22.90%,59.54%,57.25%,21.37%,19.08%,32.82%,53.44%,64.12% in SLE group respectively,which were significantly higher than those in the other AID group and the healthy control group(P< 0.05).Com-bined dsDNA and Sm with Ro-52,SSA,Nucleosome,Rib-P,C3 and C4 respectively.The positive rate of each combined detection mode in SLE group was remarkably higher than the other AID group(P<0.05).Besides, the positive rate of the mode contained Ro-52,SSA,Rib-P,complement(C3 and C4)respectively was higher than the combined mode of dsDNA and Sm alone(P<0.05).Conclusion The antibodies against Sm,Ro-52, SSA,dsDNA,Nucleosome,Rib-P,C3 and C4 have important diagnostic value for SLE.In addition,the com-bined detection mode could significantly improve the detection rate of SLE.