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目的 探讨联合检测抗核小体抗体（AnuA）、抗dsDNA抗体对系统性红斑狼疮（SLE）疾病活动和脏器损害的意义。方法 69例SLE分为疾病活动和疾病稳定组、狼疮肾炎（LN）和非狼疮肾炎组（NLN）。测定AnuA和抗dsDNA抗体水平，比较组间抗体水平差异，分析其与免疫指标的相关性。结果 AnuA和抗dsDNA抗体阳性率为55．1％和47．82％，疾病活动组显著高于疾病稳定组（P〈0.001）。抗dsDNA抗体阴性SLE中有16，6％AnuA阳性。两抗体与SLE疾病活动指数（SLEDAI）、IgG、球蛋白水平显著正相关，与C3、C4、白蛋白水平显著负相关。LN组两抗体水平均显著高于NLN。结论 AnuA和抗dsDNA抗体都是SLE疾病活动指标，与LN相关，AnuA检测是对抗dsDNA抗体的有益补充。
红斑狼疮,系统性 抗体,抗核 核小体 DNA
Significance of combination of serum anti-nucleosome and anti-dsDNA antibodies in patients with systemic lupus erythematosus
Objective To explore the significance of anti-nucleosome and anti-dsDNA antibodies on the disease flare and organ damage in patients with systemic lupus erythematosus （SLE）. Methods Sixty-nine SLE patients were divided into disease flare group, stable group, lupus nephritis group and non-lupus nephritis group. Serum levels of anti-nucleosome antibody and anti-dsDNA antibody were measured with enzyme linked immunosorbent assay （ELISA） and indirect immunofluorescence （ IIF）, respectively. Results The positive rates of serum anti-nucleosome and anti-dsDNA antibodies were 55. 10% and 47.82% respectively and the rates were significantly higher in disease flare group than those in disease stable group （ P 〈 0. 001 ）. The positive rate of anti-nucleosome antibody may be positive in 16. 6% anti-dsDNA negative patients. The levels of anti-nucleosome and anti-dsDNA antibodies were positively correlated with SLEDAI, IgG and globulin and negatively with the levels of C3, C4 and albumin. Serum levels of anti-nuclesome and anti-dsDNA antibodies were higher in lupus nephritis group than those in non-lupus nephritis group. Conclusion The levels of anti-nucleosome and anti-dsDNA antibodies are index of disease activity and correlated with lupus nephritis. The detection of anti-nucleosome antibody is helpful for the diagnose of SLE patients with negative anti-dsDNA.
Lupus erythematosus,systemic; Antibodies,antinuclear; Nucleosomes; DNA