中华风湿病学杂志
中華風濕病學雜誌
중화풍습병학잡지
CHINESE JOURNAL OF RHEUMATOLOGY
2014年
4期
244-247
,共4页
曹华%万朋杰%李卫平%施若非%郑捷
曹華%萬朋傑%李衛平%施若非%鄭捷
조화%만붕걸%리위평%시약비%정첩
红斑狼疮,系统性%抗体亲和力%M-SLEDAI
紅斑狼瘡,繫統性%抗體親和力%M-SLEDAI
홍반랑창,계통성%항체친화력%M-SLEDAI
Lupus erythematosus,systemic%Antibody affinity%Modified systemic lupus erythematosus disease activity index
目的 比较不同亲和力的抗dsDNA抗体在SLE诊断中的临床意义.方法 用ELISA检测431份血清中总抗dsDNA抗体(包括高亲和力和低亲和力抗dsDNA抗体)与高亲和力抗dsDNA抗体水平.收集标本时,评价SLE患者的M-SLEDAI得分.采用x2检验、Spearman相关、Mann Whitney U检验和Fisher exact方法、Student t检验.结果 ①所有血清总抗dsDNA抗体与高亲和力抗dsDNA抗体的总的一致性为93.3％; SLE患者总抗dsDNA抗体与高亲和力抗dsDNA抗体一致性为89.6％,有23例SLE患者总抗dsDNA抗体阳性而高亲和力抗dsDNA抗体阴性,其中22例(占95.7％)的M-SLEDAI评分＜4分;4例其他CTD患者血清总抗dsDNA抗体阳性,而高亲和力抗dsDNA抗体阴性.②SLE患者血清总抗dsDNA抗体(r=0.57,P＜0.01)以及高亲和力抗dsDNA抗体水平(r=0.59,P＜0.01)均与M-SLEDAI评分呈正相关,与血清中补体C3(r=-0.50,P＜0.01;r=-0.54,P＜0.01)和C4(r=-0.50,P＜0.01;r=-0.50,P＜0.01)水平呈相关.③M-SLEDAI评分≥4分的患者血清中高亲和力占总抗dsDNA抗体的比例显著高于M-SLEDAI评分＜4分的患者.伴肾脏损害患者高亲和力抗dsDNA抗体所占比例显著高于不伴肾脏损害的患者.结论 血清中总抗dsDNA抗体和高亲和力抗dsDNA抗体水平均与SLE病情活动性以及肾脏损害相关,但是高亲和力抗dsDNA抗体对活动性SLE患者更具有特异性,也更有助于SLE与其他自身免疫病鉴别.检测血清中高亲和力抗dsDNA抗体比检测总抗dsDNA抗体更能客观了解SLE的受累状况.
目的 比較不同親和力的抗dsDNA抗體在SLE診斷中的臨床意義.方法 用ELISA檢測431份血清中總抗dsDNA抗體(包括高親和力和低親和力抗dsDNA抗體)與高親和力抗dsDNA抗體水平.收集標本時,評價SLE患者的M-SLEDAI得分.採用x2檢驗、Spearman相關、Mann Whitney U檢驗和Fisher exact方法、Student t檢驗.結果 ①所有血清總抗dsDNA抗體與高親和力抗dsDNA抗體的總的一緻性為93.3％; SLE患者總抗dsDNA抗體與高親和力抗dsDNA抗體一緻性為89.6％,有23例SLE患者總抗dsDNA抗體暘性而高親和力抗dsDNA抗體陰性,其中22例(佔95.7％)的M-SLEDAI評分＜4分;4例其他CTD患者血清總抗dsDNA抗體暘性,而高親和力抗dsDNA抗體陰性.②SLE患者血清總抗dsDNA抗體(r=0.57,P＜0.01)以及高親和力抗dsDNA抗體水平(r=0.59,P＜0.01)均與M-SLEDAI評分呈正相關,與血清中補體C3(r=-0.50,P＜0.01;r=-0.54,P＜0.01)和C4(r=-0.50,P＜0.01;r=-0.50,P＜0.01)水平呈相關.③M-SLEDAI評分≥4分的患者血清中高親和力佔總抗dsDNA抗體的比例顯著高于M-SLEDAI評分＜4分的患者.伴腎髒損害患者高親和力抗dsDNA抗體所佔比例顯著高于不伴腎髒損害的患者.結論 血清中總抗dsDNA抗體和高親和力抗dsDNA抗體水平均與SLE病情活動性以及腎髒損害相關,但是高親和力抗dsDNA抗體對活動性SLE患者更具有特異性,也更有助于SLE與其他自身免疫病鑒彆.檢測血清中高親和力抗dsDNA抗體比檢測總抗dsDNA抗體更能客觀瞭解SLE的受纍狀況.
목적 비교불동친화력적항dsDNA항체재SLE진단중적림상의의.방법 용ELISA검측431빈혈청중총항dsDNA항체(포괄고친화력화저친화력항dsDNA항체)여고친화력항dsDNA항체수평.수집표본시,평개SLE환자적M-SLEDAI득분.채용x2검험、Spearman상관、Mann Whitney U검험화Fisher exact방법、Student t검험.결과 ①소유혈청총항dsDNA항체여고친화력항dsDNA항체적총적일치성위93.3％; SLE환자총항dsDNA항체여고친화력항dsDNA항체일치성위89.6％,유23례SLE환자총항dsDNA항체양성이고친화력항dsDNA항체음성,기중22례(점95.7％)적M-SLEDAI평분＜4분;4례기타CTD환자혈청총항dsDNA항체양성,이고친화력항dsDNA항체음성.②SLE환자혈청총항dsDNA항체(r=0.57,P＜0.01)이급고친화력항dsDNA항체수평(r=0.59,P＜0.01)균여M-SLEDAI평분정정상관,여혈청중보체C3(r=-0.50,P＜0.01;r=-0.54,P＜0.01)화C4(r=-0.50,P＜0.01;r=-0.50,P＜0.01)수평정상관.③M-SLEDAI평분≥4분적환자혈청중고친화력점총항dsDNA항체적비례현저고우M-SLEDAI평분＜4분적환자.반신장손해환자고친화력항dsDNA항체소점비례현저고우불반신장손해적환자.결론 혈청중총항dsDNA항체화고친화력항dsDNA항체수평균여SLE병정활동성이급신장손해상관,단시고친화력항dsDNA항체대활동성SLE환자경구유특이성,야경유조우SLE여기타자신면역병감별.검측혈청중고친화력항dsDNA항체비검측총항dsDNA항체경능객관료해SLE적수루상황.
Objective To investigate the clinical utility of anti-dsDNA antibody in the diagnosis of systemic lupus erythematosus (SLE).Methods Total and high affinity anti-dsDNA antibodies of 431 serum samples were measured by total and high affinity anti-dsDNA antibody EIA kits.Modified SLE disease activity index (M-SLEDAI) was scored for each SLE patients at the time of serum collection.The agreements between total and high affinity anti-dsDNA EIA tests and the correlation of anti-dsDNA antibody levels with disease activity and clinical manifestations were analyzed.Statistical analysis was performed using x2 test,Spearman correlation,Mann Whitney U test & Fisher exact,Student t test.Results ① The overall agreement between total and high affinity anti-dsDNA antibodies was 93.3％,and the total agreement of SLE patients was 89.6％.Twenty-two out of 23 (95.7％) SLE patients with positive total anti-dsDNA antibody but high affinity antidsDNA antibody were inactive with the M-SLEDAI score less than 4.Four patients with other autoimmune diseases had positive total anti-dsDNA antibody but negative on high affinity anti-dsDNA antibodies.② The total and high affinity anti-dsDNA antibody levels were significantly positively correlated with disease activity (M-SLEDAI) and negatively correlated with serum C3 and C4 levels (P＜0.01).③ The ratio of high affinity to total anti-dsDNA antibody was significantly higher in patients with M-SLEDAI ≥4 or with active kidney damage (P＜0.01).Conclusion Both total and high affinity anti-dsDNA antibodies are significantly correlated with SLE disease activity and kidney damage.However,the high affinity anti-dsDNA antibody may be more specific for active SLE and helpful in the differential diagnosis with other autoimmune diseases.High affinity anti-dsDNA antibody is more valuable in monitoring SLE disease activity status,especially on kidney damage,compared to total anti-dsDNA antibodies.
