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目的:研究抗核小体抗体(ANuA)在系统性红斑狼疮(systemic lupuserythematosus,SLE)患者血清中的水平。评价ANuA对SLE诊断的敏感性和特异性,探讨ANuA在SLE诊治中的作用和意义。方法:采用酶联免疫吸附法(ELISA)测定58例SLE患者、65例其他风湿性疾病(包括类风湿性关节炎、原发性干燥综合征、系统性硬化症和结缔组织病)和30名健康对照血清中ANuA水平。同时检测抗双链DNA抗体(dsDNA)和抗Sm抗体。结果:自身抗体在SLE及其他风湿病对照组的阳性率分别为ANuA62.1%和3.1%,抗ds-DNA抗体48.3%和4.6%,抗Sm抗体39.6%和0。ANuA对SLE的诊断敏感性和特异性分别为62.1%和96.9%。ANuA与抗ds-DNA、Sm抗体联合检测对SLE诊断敏感性提高,为70.7%,同时有92.3%的特异性。结论:ANuA在SLE血清中水平显著增高,ANuA测定是SLE诊断和治疗监测中有价值的新的实验室检测指标之一,与抗ds-DNA和Sm抗体联合检测可提高诊断SLE的敏感性。
Objective: To study the level of anti-nucleosome antibody (ANuA) in the serum of patients with systemic lupus erythematosus (SLE). To evaluate the sensitivity and specificity of ANuA for the diagnosis of SLE and to explore the role and significance of ANuA in the diagnosis and treatment of SLE. Methods: Fifty-eight patients with SLE, 65 other rheumatic diseases including rheumatoid arthritis, Sjogren’s syndrome, systemic sclerosis and connective tissue disease were measured by enzyme-linked immunosorbent assay (ELISA) and 30 Healthy control serum ANuA levels. Simultaneous detection of anti-dsDNA and anti-Sm antibodies. Results: The positive rates of autoantibodies in SLE and other rheumatoid arthritis control groups were 62.1% and 3.1% of ANuA, 48.3% and 4.6% of anti-dsDNA and 39.6% and 0 of anti-Sm antibody respectively. The diagnostic sensitivity and specificity of ANuA for SLE were 62.1% and 96.9%, respectively. The combined detection of ANuA and anti-ds-DNA and Sm antibody increased the sensitivity of SLE diagnosis to 70.7% with 92.3% specificity. CONCLUSIONS: The level of ANuA is significantly increased in SLE serum. The ANuA assay is one of the valuable new laboratory tests for the diagnosis and treatment of SLE. Combined with anti-ds-DNA and Sm antibodies, it is possible to improve the sensitivity of SLE diagnosis.