中华风湿病学杂志
中華風濕病學雜誌
중화풍습병학잡지
CHINESE JOURNAL OF RHEUMATOLOGY
2012年
1期
27-32
,共6页
茹晋丽%赵越%张莉芸%罗静%吕志勤%赵华明
茹晉麗%趙越%張莉蕓%囉靜%呂誌勤%趙華明
여진려%조월%장리예%라정%려지근%조화명
红斑狼疮,系统性%诊断%自身抗体%抗cmDNA抗体
紅斑狼瘡,繫統性%診斷%自身抗體%抗cmDNA抗體
홍반랑창,계통성%진단%자신항체%항cmDNA항체
Lupus erythematosus,systemic%Diagnosis%Autoantibodies%Autoantibody to cell membrane associated DNA
目的 应用间接免疫荧光法(IIF)检测抗细胞膜DNA(cmDNA)抗体,探讨抗cmDNA抗体对系统性红斑狼疮(SLE)的诊断价值.比较以人B淋巴细胞株Raji、人早幼粒白血病细胞株HL60为底物,抗cmDNA抗体在SLE中的检测效果.方法 选取306例SLE患者,192例非SLE疾病对照组,包括脊柱关节病(SPA) 52例,类风湿关节炎(RA) 70例,原发干燥综合征(pSS) 30例,其他结缔组织病(CTD)40例.50名健康志愿者作为对照组.采用IIF法观察培养的人B淋巴细胞株Raji、人早幼粒白血病细胞株HL60的细胞膜的荧光图形；用IIF法检测抗核抗体、抗双链DNA(dsDNA)抗体；联合应用免疫双扩散法和蛋白印迹法检测抗Sm抗体,酶联免疫吸附试验(ELISA)法测定抗核小体抗体(AnuA).配对资料比较用McNemarX2检验,相关性分析采用Spearman相关及Logistic回归分析.结果以Raji及HL60 2种细胞株为底物检测SLE患者抗cmDNA抗体,敏感性分别为72.5％、76.1％,特异性分别为91.7％、86.8％,差异均无统计学意义(P＞0.05).抗cmDNA抗体的敏感性明显高于抗Sm抗体及抗dsDNA抗体,差异有统计学意义(P＜0.01)；特异性与抗dsDNA抗体相似(P＞0.05),日低于抗Sm抗体及AnuA(P＜0.01).抗cmDNA抗体分别与抗dsDNA抗体、抗Sm抗体及AnuA联合检测在SLE诊断中的敏感性均明显高于上述自身抗体单独检测,差异有统计学意义(P＜0.05).抗cmDNA抗体与SLE患者的黏膜溃疡之间有相关性(OR=2.343,P=0.029).抗cmDNA抗体与红细胞沉降率(ESR)有相关性(OR=1.031,P=0.012).抗cmDNA抗体与SLE疾病活动指数(SLEDAI)评分无相关性(r=0.070,P=0.600).本文研究还证实Raji细胞株较HL60细胞株更易复苏、荧光图形亮度更强,表达效果更好.结论 抗cmDNA抗体对SLE诊断的敏感性高,特异性强,可能成为SLE诊断的相对特异性抗体之一.抗cmDNA抗体与抗dsDNA抗体、抗Sm抗体及AnuA联合检测可提高对SLE诊断的敏感性.选择Raji细胞株为底物检测抗cmDNA抗体较HL60细胞株更有优势.
目的 應用間接免疫熒光法(IIF)檢測抗細胞膜DNA(cmDNA)抗體,探討抗cmDNA抗體對繫統性紅斑狼瘡(SLE)的診斷價值.比較以人B淋巴細胞株Raji、人早幼粒白血病細胞株HL60為底物,抗cmDNA抗體在SLE中的檢測效果.方法 選取306例SLE患者,192例非SLE疾病對照組,包括脊柱關節病(SPA) 52例,類風濕關節炎(RA) 70例,原髮榦燥綜閤徵(pSS) 30例,其他結締組織病(CTD)40例.50名健康誌願者作為對照組.採用IIF法觀察培養的人B淋巴細胞株Raji、人早幼粒白血病細胞株HL60的細胞膜的熒光圖形；用IIF法檢測抗覈抗體、抗雙鏈DNA(dsDNA)抗體；聯閤應用免疫雙擴散法和蛋白印跡法檢測抗Sm抗體,酶聯免疫吸附試驗(ELISA)法測定抗覈小體抗體(AnuA).配對資料比較用McNemarX2檢驗,相關性分析採用Spearman相關及Logistic迴歸分析.結果以Raji及HL60 2種細胞株為底物檢測SLE患者抗cmDNA抗體,敏感性分彆為72.5％、76.1％,特異性分彆為91.7％、86.8％,差異均無統計學意義(P＞0.05).抗cmDNA抗體的敏感性明顯高于抗Sm抗體及抗dsDNA抗體,差異有統計學意義(P＜0.01)；特異性與抗dsDNA抗體相似(P＞0.05),日低于抗Sm抗體及AnuA(P＜0.01).抗cmDNA抗體分彆與抗dsDNA抗體、抗Sm抗體及AnuA聯閤檢測在SLE診斷中的敏感性均明顯高于上述自身抗體單獨檢測,差異有統計學意義(P＜0.05).抗cmDNA抗體與SLE患者的黏膜潰瘍之間有相關性(OR=2.343,P=0.029).抗cmDNA抗體與紅細胞沉降率(ESR)有相關性(OR=1.031,P=0.012).抗cmDNA抗體與SLE疾病活動指數(SLEDAI)評分無相關性(r=0.070,P=0.600).本文研究還證實Raji細胞株較HL60細胞株更易複囌、熒光圖形亮度更彊,錶達效果更好.結論 抗cmDNA抗體對SLE診斷的敏感性高,特異性彊,可能成為SLE診斷的相對特異性抗體之一.抗cmDNA抗體與抗dsDNA抗體、抗Sm抗體及AnuA聯閤檢測可提高對SLE診斷的敏感性.選擇Raji細胞株為底物檢測抗cmDNA抗體較HL60細胞株更有優勢.
목적 응용간접면역형광법(IIF)검측항세포막DNA(cmDNA)항체,탐토항cmDNA항체대계통성홍반랑창(SLE)적진단개치.비교이인B림파세포주Raji、인조유립백혈병세포주HL60위저물,항cmDNA항체재SLE중적검측효과.방법 선취306례SLE환자,192례비SLE질병대조조,포괄척주관절병(SPA) 52례,류풍습관절염(RA) 70례,원발간조종합정(pSS) 30례,기타결체조직병(CTD)40례.50명건강지원자작위대조조.채용IIF법관찰배양적인B림파세포주Raji、인조유립백혈병세포주HL60적세포막적형광도형；용IIF법검측항핵항체、항쌍련DNA(dsDNA)항체；연합응용면역쌍확산법화단백인적법검측항Sm항체,매련면역흡부시험(ELISA)법측정항핵소체항체(AnuA).배대자료비교용McNemarX2검험,상관성분석채용Spearman상관급Logistic회귀분석.결과이Raji급HL60 2충세포주위저물검측SLE환자항cmDNA항체,민감성분별위72.5％、76.1％,특이성분별위91.7％、86.8％,차이균무통계학의의(P＞0.05).항cmDNA항체적민감성명현고우항Sm항체급항dsDNA항체,차이유통계학의의(P＜0.01)；특이성여항dsDNA항체상사(P＞0.05),일저우항Sm항체급AnuA(P＜0.01).항cmDNA항체분별여항dsDNA항체、항Sm항체급AnuA연합검측재SLE진단중적민감성균명현고우상술자신항체단독검측,차이유통계학의의(P＜0.05).항cmDNA항체여SLE환자적점막궤양지간유상관성(OR=2.343,P=0.029).항cmDNA항체여홍세포침강솔(ESR)유상관성(OR=1.031,P=0.012).항cmDNA항체여SLE질병활동지수(SLEDAI)평분무상관성(r=0.070,P=0.600).본문연구환증실Raji세포주교HL60세포주경역복소、형광도형량도경강,표체효과경호.결론 항cmDNA항체대SLE진단적민감성고,특이성강,가능성위SLE진단적상대특이성항체지일.항cmDNA항체여항dsDNA항체、항Sm항체급AnuA연합검측가제고대SLE진단적민감성.선택Raji세포주위저물검측항cmDNA항체교HL60세포주경유우세.
Objective To compare the significance of anti-cmDNA antibody in systemic lupus erythematosus (SLE) patients detected with IIF on human's B lymphoma cell line Raji and promyelocytic line HL60.The diagnostic value of anti-cmDNA antibody in SLE was also explored.Methods Three hundred and six patients with SLE were included in this study.As control groups,we included 192 patients with other rheumatic diseases and 50 healthy controls.The testing method for anti-cmDNA antibody was set up.The assessment of the significance of anti-cmDNA antibody in SLE detected with IIF on cell line Raji and HL60 was carried out and the diagnostic value of anti-cmDNA antibody in SLE was investigated.ANA and antidsDNA antibody were measured by IIF at the same time.Anti-Sm was measured by immuno-diffusion and Western blotting.AnuA was tested by enzyme linked immunosorbent assay.The statistical methods used in this study including McNemar X2 test,Spearman related test and Logistic regression analysis.Results The fluorescence brightness of Raji cell line was stronger than HL60 cell line.There was no statistically significant difference in the sensitivity and specificity of anti-cmDNA antibody in SLE detected with IIF with Raji or HL60 cell lines (P＞0.05).The sensitivity of anti-cmDNA antibody detected with IIF on Raji cell line was higher than anti-dsDNA antibody and anti-Sm antibody (P＜0.01),while the specificity of anti-cmDNA antibody was similar to anti-dsDNA antibody (P＞0.05) and was lower than anti-Sin antibody (P＜0.01).The sensitivity of anti-cmDNA antibody was similar to AnuA (P＞0.05) and the specificity was lower than AnuA (P＜0.01).The sensitivity of ANA was higher than anti-cmDNA antibody (P＜0.01) and the specificity was much lower than anti-cmDNA antibody (P＜0.01).The sensitivities of anti-dsDNA antibody,anti-Sm antibody and AnuA were much higher when combined with anti-dsDNA antibody than any one antibody only (P＜0.05).Anti-cmDNA antibody was correlated with mucosa ulcer in SLE patients (OR=2.343,P=0.029).The ESR of SLE patients was also correlated with anti-cmDNA antibody(OR=l.031,P=0.012).Anti-cmDNA antibody was not correlated with SLEDAI (r=0.070,P=0.600).Conclusion Raji cell line is better than HL60 cell line in detecting anti-cmDNA antibody with IIF.Anti-cmDNA antibody has higher sensitivity and specificity in SLE.Combined detection of anti-cmDNA antibody and other autoantibodies can further improve the diagnostic accuracy of SLE.
