抗细胞膜DNA抗体联合抗核抗体检测在系统性红斑狼疮诊断中的价值

Diagnostic value of anti-cell membrane DNA antibody combined with antinuclear antibody for systemic lupus erythematosus

摘要:

目的 探讨抗细胞膜DNA（cmDNA）抗体联合抗核抗体（ANA）检测在系统性红斑狼疮（SLE）诊断中的应用价值。方法 选取2016年1月—2017年12月海南省中医院检验科确诊的182例SLE患者为观察组，纳入同期确诊的85例其他自身免疫性疾病患者为疾病对照组，包括类风湿关节炎患者29例、原发干燥综合征患者33例、脊柱关节病患者12例、其他结缔组织病患者11例，纳入50例健康志愿者为健康对照组。采用间接免疫荧光法检测3组对象ANA及抗cmDNA抗体，采用欧蒙印迹法测定抗史密斯（Sm）抗体、抗核小体抗体（AnuA）。结果 观察组抗cmDNA抗体、ANA、抗Sm抗体、AnuA阳性率均高于其他各组（P?<0.05）。各抗体对诊断SLE敏感性，ANA最高，其次为AnuA、抗cmDNA抗体，抗Sm抗体最低；特异性，抗Sm抗体和AnuA最高，其次为抗cmDNA抗体，ANA最低；阳性预测值，AnuA最高，其次为抗Sm抗体和抗cmDNA抗体，ANA最低；阴性预测值，ANA最高，其次为AnuA和抗cmDNA抗体，抗Sm抗体最低，上述总体差异有统计学意义（P?<0.05）。观察组中ANA、抗Sm抗体、AnuA阴性者，抗cmDNA检出率分别54.55%、64.54%和59.57%。抗cmDNA抗体并联常规方案诊断SLE的敏感性最高，抗cmDNA抗体串联ANA诊断SLE的特异性最高。结论 抗cmDNA抗体有助于检出ANA、抗Sm抗体及AnuA阴性的SLE患者，抗cmDNA抗体联合常规方案诊断SLE具备较可靠的诊断效能。

Abstract:

Objective To explore the diagnostic value of anti-cell membrane DNA (cmDNA) antibody combined with antinuclear antibody (ANA) for systemic lupus erythematosus (SLE). Methods A total of 182 patients diagnosed with SLE from January 2016 to December 2017 were included in the observation group, and 85 patients with other autoimmune diseases including 29 cases with rheumatoid arthritis, 33 cases with primary Sjogren syndrome, 12 cases with spondylitis and 11 cases with other connective tissue diseases were involved in case-control group. A total of 50 healthy volunteers were included in the healthy-control group. ANA and anti cmDNA antibodies were detected by indirect immunofluorescence. Anti-Smith (Sm) antibody and anti-nucleosome antibody (AnuA) were measured by the EURO line. Results The positive rate of anti cmDNA antibody, ANA, anti Sm antibody and AnuA in the observation group were significantly increased when compared with those in the other groups (P?