抗核小体抗体在系统性红斑狼疮诊断中的应用
Anti-nucleosome antibodies in the diagnosis of systemic lupus erythematosus.
作者信息
Julkunen H, Salonen E M, Walle T K, Miettinen A
机构信息
Department of Internal Medicine, Peijas Hospital, Vantaa, Finland.
出版信息
Scand J Rheumatol. 2005 Mar-Apr;34(2):122-4. doi: 10.1080/02813430510015250-1.
OBJECTIVE
To study the prevalence and diagnostic significance of antibodies against nucleosomes in patients with systemic lupus erythematosus (SLE) as compared to five anti-nuclear antibody (ANA) assays.
METHODS
The study included 305 patients with SLE, 125 patients with other autoimmune rheumatic diseases, and 415 healthy controls. Anti-nucleosome antibodies were measured by an enzyme-linked immunosorbent assay (ELISA) and ANA by immunofluorescence (IF) using Hep-2 cells. Anti-double-stranded DNA (anti-dsDNA) antibodies were measured by three commercial ELISAs and by IF using Crithidia luciliae as antigen.
RESULTS
Compared to three ELISAs for anti-dsDNA, the anti-nucleosome assay was less sensitive (30% vs. 29-69%) but equally specific (90% vs. 77-95%) for SLE. The most sensitive test was ANA (76%), and the least sensitive was Crithidia (13%). The correlations between the different assays were good (p < 0.001 for all comparisons).
CONCLUSION
The anti-nucleosome antibody assay does not offer additional information compared to conventionally used anti-dsDNA tests in the differential diagnosis of SLE.
目的
与五种抗核抗体（ANA）检测方法相比，研究系统性红斑狼疮（SLE）患者中抗核小体抗体的患病率及诊断意义。
方法
该研究纳入了305例SLE患者、125例其他自身免疫性风湿疾病患者以及415例健康对照。采用酶联免疫吸附测定（ELISA）检测抗核小体抗体，使用Hep-2细胞通过免疫荧光（IF）检测ANA。采用三种商业ELISA试剂盒以及以亮绿蝇短膜虫为抗原通过IF检测抗双链DNA（抗dsDNA）抗体。
结果
与三种抗dsDNA的ELISA检测方法相比，抗核小体检测对SLE的敏感性较低（30%对29%-69%），但特异性相同（90%对77%-95%）。最敏感的检测方法是ANA（76%），最不敏感的是亮绿蝇短膜虫检测（13%）。不同检测方法之间的相关性良好（所有比较的p<0.001）。
结论
在SLE的鉴别诊断中，与传统使用的抗dsDNA检测相比，抗核小体抗体检测并未提供额外信息。
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