Sharp G C, Irvin W S, May C M, Holman H R, McDuffie F C, Hess E V, Schmid F R
N Engl J Med. 1976 Nov 18;295(21):1149-54. doi: 10.1056/NEJM197611182952101.
Extractable nuclear antigen contains ribo-nuclease-sensitive (ribonucleoprotein) and ribonuclease-resistant (Sm) components. To determine the diagnostic usefulness of antibodies to these antigens, a multicenter study was undertaken in which serums were analyzed for these antibodies and the findings compared with clinical and other laboratory characteristics of the patients. Of 100 patients with hemagglutinating antibodies to ribonuclease-sensitive extractable nuclear antigen, and only the same antibodies by immunodiffusion, 74 per cent had typical features of mixed connective-tissue disease; 12 features of systemic lupus erythematosus, eight those of scleroderma and six an undifferentiated mild connective-tissue disease. Of 27 patients with hemagglutinating antibodies to ribonuclease-resistant extractable nuclear antigen (and Sm antibodies by immunodiffusion), 85 per cent had typical systemic lupus. Thus, antibodies to nuclear ribonucleoprotein and Sm are of diagnostic use; if the serum contains only ribonucleoprotein antibody in high titer, it is likely that the patient has mixed connective-tissue disease.
可提取核抗原包含核糖核酸酶敏感（核糖核蛋白）和核糖核酸酶抗性（Sm）成分。为了确定针对这些抗原的抗体的诊断效用，开展了一项多中心研究，其中分析血清中的这些抗体，并将结果与患者的临床及其他实验室特征进行比较。在100例对核糖核酸酶敏感的可提取核抗原有血凝抗体且仅通过免疫扩散检测出相同抗体的患者中，74%具有混合性结缔组织病的典型特征；12例有系统性红斑狼疮特征，8例有硬皮病特征，6例有未分化的轻度结缔组织病特征。在27例对核糖核酸酶抗性的可提取核抗原有血凝抗体（通过免疫扩散检测为Sm抗体）的患者中，85%有典型的系统性红斑狼疮。因此，针对核糖核蛋白和Sm的抗体具有诊断用途；如果血清中仅含有高滴度的核糖核蛋白抗体，则患者很可能患有混合性结缔组织病。
