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目的研究抗SmD1抗体及其他特异性抗体在系统性红斑狼疮(SLE)诊断中的意义。方法测定了44例SLE及136例非SLE(包括干燥综合征、未分化结缔组织病、强直性脊柱炎、类风湿关节炎)患者血清中的自身抗体。利用免疫印迹法测定抗SmD1抗体、抗核小体抗体(ANuA)和抗SSA60 000抗体,间接免疫荧光法测定抗核抗体(ANA)和抗双链DNA(dsDNA)抗体,免疫斑点法检测抗Sm抗体。结果抗SmD1抗体在SLE患者中的阳性率为47.7%,高于抗Sm抗体阳性率18.2%,差异有统计学意义(P<0.05),而且其抗SmD1抗体的特异性达97.1%。结论抗SmD1抗体在狼疮的诊断中有很高的特异性,敏感性也高于抗Sm抗体。5种特异性抗体在SLE诊断中有明显的互补作用,联合检测可明显提高其对SLE诊断的敏感性。
Objective To study the significance of anti-SmD1 antibody and other specific antibodies in the diagnosis of systemic lupus erythematosus (SLE). Methods Serum autoantibodies were measured in 44 patients with SLE and 136 patients with non-SLE (including Sjogren’s syndrome, undifferentiated connective tissue disease, ankylosing spondylitis, and rheumatoid arthritis). Anti-SmD1 antibody, anti-nucleosome antibody (ANuA) and anti-SSA60 000 antibody were determined by Western blotting, anti-nuclear antibody (ANA) and anti-dsDNA antibody were detected by indirect immunofluorescence, anti-Sm antibody. Results The positive rate of anti-SmD1 antibody in SLE patients was 47.7%, which was higher than that of anti-Sm antibody in 18.2% (P <0.05), and the anti-SmD1 antibody specificity was 97.1%. Conclusion The anti-SmD1 antibody is highly specific in the diagnosis of lupus and is more sensitive than anti-Sm antibody. Five kinds of specific antibodies in the diagnosis of SLE obvious complementarity, combined detection can significantly improve its sensitivity to SLE diagnosis.