新蝶呤与抗DNA抗体水平联合评估对系统性红斑狼疮疾病活动度评估的诊断价值
Diagnostic value of combined evaluation of neopterin and anti-DNA antibody levels for assessment of disease activity in systemic lupus erythematosus.
作者信息
Nagy G, Brózik M, Tornóci L, Gergely P
机构信息
3rd Department of Internal Medicine, Semmelweis University, Budapest, Hungary.
出版信息
Clin Exp Rheumatol. 2000 Nov-Dec;18(6):699-705.
OBJECTIVE
The present study was designed to investigate whether the combined evaluation of laboratory tests could improve their diagnostic value. Laboratory parameters of systemic lupus erythematosus (SLE), such as anti-dsDNA, neopterin, soluble IL-2 receptor (sIL-2R), C3, C4, and complement haemolytic activity (CH50), and a logistic model that provides the probable clinical activity (PCA) of a given patient, calculated by stepwise multiple logistic regression analysis from the parameters mentioned above--were evaluated as SLE activation markers.
METHODS
Serum samples from 101 patients were assayed by ELISA (neopterin, sIL-2R, anti-dsDNA), radial immunodiffusion (C3, C4) and haemolytic complement assay (CH50).
RESULTS
Among the parameters investigated, PCA showed the greatest difference between the values representing active and inactive stages of the disease (p < 0.001), the highest correlation with SLEDAI (p < 0.001) and the highest sensitivity and specificity values (0.91, 0.88, respectively). Moreover, this value of PCA was the most useful in discriminating between active and inactive sample pairs.
CONCLUSION
We conclude that PCA is more useful in evaluating SLE activity than the single parameters studied.
目的
本研究旨在调查实验室检查的联合评估是否能提高其诊断价值。对系统性红斑狼疮（SLE）的实验室参数，如抗双链DNA、新蝶呤、可溶性白细胞介素-2受体（sIL-2R）、C3、C4和补体溶血活性（CH50），以及通过对上述参数进行逐步多元逻辑回归分析计算得出的、提供给定患者可能临床活动度（PCA）的逻辑模型，作为SLE活动标志物进行评估。
方法
采用酶联免疫吸附测定法（ELISA）（检测新蝶呤、sIL-2R、抗双链DNA）、放射免疫扩散法（检测C3、C4）和溶血补体测定法（检测CH50）对101例患者的血清样本进行检测。
结果
在所研究的参数中，PCA在代表疾病活动期和非活动期的值之间显示出最大差异（p < 0.001），与系统性红斑狼疮疾病活动指数（SLEDAI）的相关性最高（p < 0.001），且敏感性和特异性值最高（分别为0.91和0.88）。此外，PCA值在区分活动样本对和非活动样本对方面最有用。
结论
我们得出结论，PCA在评估SLE活动度方面比所研究的单个参数更有用。
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