Swaak A J, Huysen V, Nossent J C, Smeenk R J
Department of Rheumatology, Dr Daniel den Hoed Clinic, Rotterdam, The Netherlands.
Clin Rheumatol. 1990 Mar;9(1 Suppl 1):82-94. doi: 10.1007/BF02205555.
The aim of the study was to investigate the prevalence of antinuclear and associated antibodies (anti-dsDNA, anticardiolipin, anti-RNP, anti-Sm, anti-SSA and anti-SSB) and/or combinations thereof in systemic lupus erythematosus (SLE) patients with respect to their diagnostic and pathogenetic significance. The prevalence of anti-dsDNA antibodies was strongly influenced by the selection criteria of the patient; the lowest prevalence was found in SLE patients with central nervous system (CNS) involvement; the highest prevalence in patients with nephritis. The results were also influenced by the different assays. Combinding different assays (Farr/PEG ratio) quantitative as well as qualitative differences could be shown between patients with nephritis (Farr/PEG ratio greater than or equal to 5) and with CNS involvement (Farr/PEG ratio less than 5). No difference in anticardiolipin antibody prevalence between the different SLE patient groups could be demonstrated. Regarding antibodies against RNP, Sm, SSA and SSB, the prevalence was found to be strongly influenced by the criteria used for patient selection. Only in CNS patients and association with anti-RNP and anti-SSB antibodies alone or in combination was found. In pleuropericarditis a weak association with RNP antibodies existed.
studying the prevalence and possible pathogenetic significance of antibodies one should always consider patient selection criteria and the effect of the different assays used when analysing the results.
本研究的目的是调查系统性红斑狼疮(SLE)患者中抗核抗体及相关抗体(抗双链DNA、抗心磷脂、抗核糖核蛋白、抗史密斯、抗干燥综合征A抗原和抗干燥综合征B抗原)及其组合的患病率,并探讨其诊断和发病机制意义。抗双链DNA抗体的患病率受患者选择标准的影响很大;中枢神经系统(CNS)受累的SLE患者患病率最低;肾炎患者患病率最高。结果也受不同检测方法的影响。结合不同检测方法(Farr/PEG比值),可显示肾炎患者(Farr/PEG比值大于或等于5)和CNS受累患者(Farr/PEG比值小于5)之间存在定量和定性差异。不同SLE患者组之间抗心磷脂抗体患病率无差异。关于抗核糖核蛋白、抗史密斯、抗干燥综合征A抗原和抗干燥综合征B抗原抗体,发现患病率受患者选择标准的强烈影响。仅在CNS患者中发现单独或联合存在抗核糖核蛋白和抗干燥综合征B抗原抗体。在胸膜炎心包炎中,与核糖核蛋白抗体存在弱关联。
在研究抗体的患病率和可能的发病机制意义时,分析结果时应始终考虑患者选择标准和所用不同检测方法的影响。