| 摘要: |
| 目的探讨抗细胞膜DNA（mDNA）抗体在系统性红斑狼疮（SLE）诊断中的应用价值。方法选择SLE患者137例（SLE患者组），同期其他自身免疫性疾病患者72例（其他自免疾病组），同期健康体检者84例（健康对照组）。采用间接免疫荧光法检测抗mDNA抗体和抗核抗体（ANA），采用ELISA法检测抗双链DNA（ds-DNA）抗体，采用免疫印迹法检测核糖体P蛋白（Rib-P）抗体、抗史密斯（Sm）抗体及抗核小体抗体（AnuA）等其他自身抗体，评价各自身抗体指标在3组血清中的灵敏度和特异度，以寻找诊断SLE的最佳免疫学指标组合。结果抗mDNA抗体在SLE患者组中的灵敏度（62.8%）明显高于其他自免疾病组（12.5%）和健康对照组（2.4%），也明显高于抗ds-DNA抗体（40.9%）、Rib-P抗体（21.2%）、抗Sm抗体（18.2%）和AnuA（17.5%），差异均有统计学意义（P＜0.05）。137例SLE患者血清中抗ds-DNA抗体、Rib-P抗体、抗Sm抗体、AnuA分别与抗mDNA抗体联合检测的灵敏度明显高于其自身单独检测的灵敏度，差异均有统计学意义（均P＜0.01）。在抗ds-DNA抗体、Rib-P抗体、抗Sm抗体、AnuA4种抗体均阴性的SLE患者中，抗mDNA抗体的阳性率达65.9%，联合其他抗体能明显提高SLE的阳性率（87.6%）。结论抗mDNA抗体是一种灵敏度较高、特异度强的SLE血清学标志之一，与其他抗体联合检测在SLE诊断中有良好的互补作用，可明显提高灵敏度，从而提高SLE的临床诊断。 |
| 关键词: 抗细胞膜 DNA 抗体 系统性红斑狼疮 灵敏度 特异度 |
| DOI：10.12056/j.issn.1006-2785.2017.39.21.2017-1602 |
| 分类号: |
| 基金项目:金华市科技计划项目（2014-3-074） |
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| Diagnostic value of anti-cell membrane DNA antibodies for systemic lupus erythematosus |
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Jinhua People's Hospital
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| Abstract: |
| Objective To assess the diagnostic value of anti-cell membrane DNA (mDNA) antibodies for systemic lupus erythematosus (SLE). Methods The serum samples from 137 SLE patients (SLE group), 72 non-SLE autoimmune diseases patients(non-SLE group) and 84 healthy subjects (control group) were collected. The antinuclear antibody (ANA) and anti-mDNA antibody were detected by indirect immunofluorescence assay, anti-double-stranded DNA (dsDNA) was detected by ELISA, ribosomal P protein (Rib-P) antibody, anti-Smith (Sm) antibody and anti-nucleosome antibody (AnuA) were detected by immunoblotting (IBT). The diagnostic values of above indicators were assessed. Results The positive rate of anti-mDNA antibody in SLE patients(62.8%) was significantly higher than that in non-SLE groups(12.5%) and control group(2.4%), which was significantly higher than that of anti-ds-DNA antibodies (40.9%), Rib-P antibody (21.2%), anti-Sm antibody (18.2%) and AnuA (17.5%)(all P＜0.05). The sensitivity of combination of anti-mDNA antibody with anti-ds-DNA antibody, Rib-P antibody, anti-Sm antibody or AnuA for diagnosis of SLE was all significantly higher than that of anti-mDNA alone (all P＜0.01). The positive rate of anti-mDNA antibody was 65.9% in SLE patients with other antibodies negative. The combination of anti-mDNA antibody with other antibodies significantly improved the detection rate of SLE (87.6% ). Conclusion Anti-mDNA antibody is a sensitive serological marker of SLE, combination of anti-mDNA antibody with other indicators may further improve the sensitivity in diagnosis of SLE. |
| Key words: Anti-cell membrane DNA antibody Systemic lupus erythematosus Sensitivity Specificity |
