Chien J W, Lin C Y, Yang L Y
Department of Pediatrics, Taipei Veterans General Hospital, 201, Sec. 2, Shih-Pai Road, Taipei, 112, Taiwan.
Zhonghua Yi Xue Za Zhi (Taipei). 2001 May;64(5):283-91.
Systemic lupus erythematosus (SLE) is a complex autoimmune disease with various clinical and serological manifestations. Previous studies have shown the association of SLE and anti-Ro, anti-La and anti-dsDNA autoantibodies with various clinical manifestations. We investigated the relationship between these autoantibodies and clinical findings of our patients with SLE.
Eighty patients with SLE at Department of Pediatrics, Taipei Veterans General Hospital, Taiwan from October 1999 to March 2000 were enrolled in the study. Frequencies of various clinical manifestations were calculated. Autoantibodies to Ro, La and dsDNA were measured using ELISA method.
The most frequent clinical findings were arthritis (92.3%), photosensitivity (90.9%) and malar rash (86.1%). The most frequent laboratory findings were positive anti-nuclear antibody (ANA) (94.9%), low serum CH50 hemolytic titer (88.6%) and positive anti-dsDNA level (72.5%). Patients with anemia or photosensitivity had higher titers of anti-Ro antibody (Ab) than those without the respective clinical findings (p = 0.001 and 0.002, respectively). However, patients with proteinuria had lower anti-Ro Ab titers (p < 0.05). There was no correlation between clinical findings and anti-La Ab titers. Patients have higher titers of anti-dsDNA Ab if they had clinical findings of Raynauld's phenomenon, photosensitivity, arthritis, hypocomplementemia (p < 0.001), thrombocytopenia, proteinuria, or serositis (p < 0.05). No correlation was found between renal involvement and titers of various autoantibodies.
Neither anti-Ro, anti-La nor anti-dsDNA antibodies was correlated with renal involvement in patients with SLE. However, patients with proteinuria had significantly lower titers of anti-Ro Ab than those without proteinuria.
系统性红斑狼疮（SLE）是一种具有多种临床和血清学表现的复杂自身免疫性疾病。既往研究表明，SLE以及抗Ro、抗La和抗双链DNA（dsDNA）自身抗体与多种临床表现相关。我们研究了这些自身抗体与我院SLE患者临床检查结果之间的关系。
选取1999年10月至2000年3月在台湾台北荣民总医院儿科就诊的80例SLE患者纳入研究。计算各种临床表现的发生率。采用酶联免疫吸附测定（ELISA）法检测抗Ro、抗La和抗dsDNA自身抗体。
最常见的临床表现为关节炎（92.3%）、光敏性（90.9%）和颊部皮疹（86.1%）。最常见的实验室检查结果为抗核抗体（ANA）阳性（94.9%）、血清总补体溶血活性（CH50）滴度降低（88.6%）和抗dsDNA水平阳性（72.5%）。贫血或有光敏性的患者抗Ro抗体（Ab）滴度高于无相应临床表现的患者（分别为p = 0.001和0.002）。然而，有蛋白尿的患者抗Ro Ab滴度较低（p < 0.05）。临床检查结果与抗La Ab滴度之间无相关性。有雷诺现象、光敏性、关节炎、低补体血症（p < 0.001）、血小板减少、蛋白尿或浆膜炎（p < 0.05）等临床表现的患者抗dsDNA Ab滴度较高。未发现肾脏受累与各种自身抗体滴度之间存在相关性。
抗Ro、抗La和抗dsDNA抗体均与SLE患者的肾脏受累无关。然而，有蛋白尿的患者抗Ro Ab滴度显著低于无蛋白尿的患者。
