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化学发光免疫分析法与酶联免疫吸附测定法检测系统性红斑狼疮抗双链DNA抗体的方法比较

Comparisons of Anti-dsDNA Antibody Detection Methods by Chemiluminescent Immunoassay and Enzyme-Linked Immunosorbent Assay in Systemic Lupus Erythematosus.

作者信息

Chang Huang-Chen, Wu Yen-Ching, Chen Jun-Peng, Wu Yi-Da, Huang Wen-Nan, Chen Yi-Hsing, Chen Yi-Ming

机构信息

Division of Allergy, Immunology and Rheumatology, Taichung Veterans General Hospital, Taichung 40705, Taiwan.

Department of Medical Research, Taichung Veterans General Hospital, Taichung 40705, Taiwan.

出版信息

Diagnostics (Basel). 2021 Oct 20;11(11):1940. doi: 10.3390/diagnostics11111940.

Abstract

This study aimed to compare the test results of anti-double-stranded DNA (anti-dsDNA) antibodies obtained using chemiluminescent immunoassay (CIA) and enzyme-linked immunosorbent assay (ELISA), and investigate predictors of inconsistent results. This retrospective study included 502 patients who underwent CIA and ELISA to determine their anti-dsDNA antibody values within a year. We compared the diagnostic power for SLE, disease activity, and predictive power for lupus nephritis (LN). A multivariate analysis was performed to determine the predictors of inconsistencies. CIA and ELISA were moderately correlated in terms of their consistency (Cronbach's α = 0.571), and yielded comparably favorable results in terms of SLE diagnostic power and SLE disease activity. However, if the patient had LN, CIA displayed higher predictive power than ELISA (0.620 vs. 0.555, = 0.026). Compared with the CIA/ELISA double-positive group, the inconsistent group had lower anti-C1q circulating immune complexes (CIC) antibody values (OR: 0.42, 95% CI: 0.18-0.94, = 0.036), and lower SLEDAI scores (≥4) (OR: 0.33, 95% CI: 0.14-0.79, = 0.013). Anti-dsDNA antibody detection with CIA exhibited higher predictability for diagnosing LN than did ELISA. In the event of inconsistencies between anti-dsDNA methods, SLE disease activity and CIC test values should be considered simultaneously.

摘要

本研究旨在比较使用化学发光免疫分析(CIA)和酶联免疫吸附测定(ELISA)获得的抗双链DNA(抗dsDNA)抗体的检测结果,并探究结果不一致的预测因素。这项回顾性研究纳入了502例患者,这些患者在一年内接受了CIA和ELISA检测以确定其抗dsDNA抗体值。我们比较了对系统性红斑狼疮(SLE)的诊断能力、疾病活动度以及狼疮性肾炎(LN)的预测能力。进行多变量分析以确定不一致结果的预测因素。CIA和ELISA在一致性方面呈中度相关(Cronbach's α = 0.571),在SLE诊断能力和SLE疾病活动度方面产生了相当不错的结果。然而,如果患者患有LN,CIA的预测能力高于ELISA(0.620对0.555,P = 0.026)。与CIA/ELISA双阳性组相比,结果不一致组的抗C1q循环免疫复合物(CIC)抗体值较低(比值比:0.42,95%置信区间:0.18 - 0.94,P = 0.036),且SLE疾病活动指数(SLEDAI)评分较低(≥4)(比值比:0.33,95%置信区间:0.14 - 0.79,P = 0.013)。与ELISA相比,采用CIA检测抗dsDNA抗体对诊断LN具有更高的预测性。在抗dsDNA检测方法出现不一致的情况下,应同时考虑SLE疾病活动度和CIC检测值。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5193/8621573/7a3668512d9a/diagnostics-11-01940-g001.jpg

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