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目的评估自身抗体联合检测对系统性红斑狼疮(SLE)的诊断价值。方法将实验人群分为3组,即系统性红斑狼疮(SLE)组、其他自身免疫病(OAID)组和正常对照(NC)组。3组采用间接免疫荧光(IIF)法、定量酶联免疫吸附(ELISA)试验及线性免疫检测(LIA)法分别检测抗核抗体(ANA)、抗双链DNA抗体(抗dsDNA抗体)、14种特异性IgG类自身抗体,并筛选出5种SLE相关自身抗体。从实验敏感性、特异性和Youden指数三个方面评估单项自身抗体检测及其联合检测对SLE的诊断价值。结果 SLE组ANA阳性率与OAID组相比差异无统计学意义(P>0.05);抗dsDNA,nRNP/Sm,Sm,ARPA,AnuA抗体阳性率明显高于OAID组(P<0.01);抗Histone抗体阳性率高于OAID组(P<0.05)。自身抗体联合检测的敏感性、正确诊断指数明显高于单项自身抗体的检测(P<0.01),特异性与单项自身抗体检测无明显差异(P>0.05)。结论抗dsDNA,Sm,ARPA,AnuA和Histone抗体是SLE诊断的重要指标。自身抗体联合检测可明显提高SLE诊断的敏感性和正确诊断指数,降低临床对SLE诊断的误诊率。
Objective To evaluate the diagnostic value of autoantibodies in the diagnosis of systemic lupus erythematosus (SLE). Methods The experimental population was divided into three groups: systemic lupus erythematosus (SLE) group, other autoimmune diseases (OAID) group and normal control (NC) group. Anti-nuclear antibody (ANA), anti-double-stranded DNA antibody (anti-dsDNA antibody) and 14 kinds of anti-dsDNA antibody were detected in the three groups by indirect immunofluorescence assay, ELISA and LIA. Specific IgG autoantibodies and screened five SLE-related autoantibodies. To evaluate the diagnostic value of single autoantibodies and their combined detection for SLE from three aspects: experimental sensitivity, specificity and Youden index. Results The positive rate of ANA in SLE group was not significantly different from that in OAID group (P> 0.05). The positive rates of anti-dsDNA, nRNP / Sm, Sm, ARPA and AnuA antibodies were significantly higher than those in OAID group The positive rate of antibody was higher than OAID group (P <0.05). The sensitivity of autoantibodies detection was significantly higher than that of single autoantibodies (P <0.01). There was no significant difference between the detection of autoantibodies and autoantibodies (P> 0.05). Conclusion The anti-dsDNA, Sm, ARPA, AnuA and Histone antibodies are important indicators for the diagnosis of SLE. Combined detection of autoantibodies can significantly improve the sensitivity of SLE diagnosis and correct diagnosis index, reduce the clinical misdiagnosis rate of SLE diagnosis.