论文部分内容阅读
免疫系统异常是系统性红斑性狼疮(SLE)的一个主要特征,其血清学特点是血清中存在抗多种自身抗原的抗体。自发现红斑狼疮细胞(LE 细胞)现象及采用 Coons 氏间接免疫荧光技术检查抗核抗体(ANA)以来,诊断重点已集中于 ANA 检测上。不仅有报告未经治疗的活动性 SLE 总是 ANA 阳性,而且某些核抗原—抗体系统,尤其抗 DNA 抗体似乎在免疫复合物所致的肾病的发生上有重要的免疫发病机理作用。然而有些学者报告几组完全符合SLE 诊断的结缔组织疾病患者,用鼠肝、人白细胞以及颊粘膜细胞等为底物所作的间接免疫荧光检查,显示其血清 ANA 持续阴性。这些病人约占 SLE总数的5%。作者强调指出这些病人虽然 ANA 阴性,但并非缺乏血清学表现。这些 SLE 患者常常具有抗胞浆抗体。作者检查66例长期反复 ANA 阴性的临床典型的 SLE 患者,发现其血清学表现如下表。作者对上述66例鼠肝切片间接免疫荧光检查均阴性的患者,作了进一步研究,发现其中41例有抗Ro 抗体,其余的25例中18例经放射免疫测定有抗
Immune system abnormalities are a major feature of systemic lupus erythematosus (SLE) and serologically characterized by the presence of antibodies against multiple autoantigens in the serum. Since the discovery of the phenomenon of lupus erythematosus cells (LE cells) and the detection of anti-nuclear antibody (ANA) using Coons’s indirect immunofluorescence, the diagnostic focus has been on ANA detection. Not only is it reported that untreated active SLE is always ANA positive and that some nuclear antigen-antibody systems, especially anti-DNA antibodies, seem to have important immunopathogenic effects on the development of immune complex-induced nephropathy. However, some scholars have reported indirect immunofluorescence studies in several groups of patients with connective tissue disease fully diagnosed with SLE using mouse liver, human leukocytes and buccal mucosal cells as substrates, and have shown persistent negative serum ANA. These patients account for about 5% of the total SLE. The authors emphasize that although these patients are negative for ANA, they are not without a lack of serological performance. These SLE patients often have anti-cytoplasmic antibodies. The authors examined 66 patients with long-term repeated ANA negative clinical typical SLE patients and found that the serological findings are as follows. The authors further studied 66 cases of indirect immunofluorescence staining of murine liver sections and found that 41 of them had anti-Ro antibodies and 18 of the remaining 25 were resistant to radioimmunoassay