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目的:探讨系统性红斑狼疮(SLE)伴或不伴狼疮性肾炎(LN)患者的临床及血清自身抗体特点。方法:对102例SLE患者(包括LN患者)临床资料进行回顾;以间接免疫荧光法检测抗核抗体(ANA)和抗双链DNA(dsDNA)抗体,以酶斑点法检测抗SSA、SSB、U1RNP、Smith、Jo-1和SCL-70抗体。结果:102例SLE患者发病年龄13~78岁,平均35±14岁;首发症状以关节痛和蝶型红斑最多见,分别为29.4%和26.5%;在SLE引起的器官损伤中,狼疮性肾炎最常见,占63.7%;抗核抗体(ANA)、抗dsDNA、SSA、SSB、U1RNP、Smith、SCL-70和JO-1抗体阳性率分别为95.1%、38.2%、51.9%、11.8%、28.4%、21.6%、1%和0;在各种自身抗体中,抗dsDNA抗体在LN患者中的阳性率(46%)明显高于不伴有LN的SLE患者(24%)(P<0.05);而其他自身抗体阳性率在LN患者与不伴有LN的SLE患者之间没有明显差异。结论:育龄期女性出现关节痛或蝶型红斑时,应考虑SLE的可能,及时进行实验室检测,做到早期鉴定或排除。在自身抗体中,抗dsDNA抗体与LN的发病密切相关。
Objective: To investigate the clinical and serum autoantibodies in patients with systemic lupus erythematosus (SLE) with or without lupus nephritis (LN). Methods: The clinical data of 102 patients with SLE (including LN patients) were reviewed. Anti-nuclear antibody (ANA) and anti-dsDNA antibodies were detected by indirect immunofluorescence assay. Anti-SSA, SSB, U1RNP , Smith, Jo-1 and SCL-70 antibodies. Results: The onset age of 102 patients with SLE ranged from 13 to 78 years, with an average of 35 ± 14 years. The first symptoms were joint pain and butterfly erythema, which were 29.4% and 26.5% respectively. In the SLE-induced organ damage, lupus nephritis The positive rates of ANA, anti-dsDNA, SSA, SSB, U1RNP, Smith, SCL-70 and JO-1 were 95.1%, 38.2%, 51.9%, 11.8% and 28.4 %, 21.6%, 1% and 0 respectively. Among the various autoantibodies, the positive rate of anti-dsDNA antibody in LN patients was significantly higher than that in non-LN patients with SLE (46% vs 46% ; While the other autoantibody positive rate in patients with LN and LN without SLE patients no significant difference between. Conclusion: Women of childbearing age should have the possibility of SLE in the presence of arthralgia or butterfly erythema, and laboratory tests should be carried out in time to achieve early identification or exclusion. In autoantibodies, anti-dsDNA antibodies are closely related to the pathogenesis of LN.