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目的通过检测系统性红斑狼疮(SLE)患者血清中细小病毒B19(PVB19)特异性抗体,观察B19 IgM阳性与SLE病情及活动程度的相关性,探讨PVB19感染与SLE之间可能存在的联系。方法采用德国IBL Hamburg公司PVB19-VP2-IgM、IgG酶联免疫吸附试验(ELISA)检测试剂盒,检测51例SLE患者及20名正常人血清PVB19的特异性抗体。结果51例SLE患者中B19 IgM抗体阳性11例(22%)。而正常对照组都为阴性,差异有统计学意义(P＜0．01)。根据B19 IgM阳性/阴性对SLE患者分组后发现,B19 IgM阳性组SLE疾病活动评分(SLEDAI)显著高于阴性组(P＜0．05)；B19 IgM阳性组与阴性组临床特征相比,除丙氨酸转氨酶(ALT)或天冬氨酸转氨酶(AST)上升差异有统计学意义(P＜0．05)外,其余差异均无统计学意义(P＞0．05)。对5例B19 IgM阳性的SLE患者随访2年发现,这些患者临床症状显著改善,SLEDAI评分显著下降(P＜0．05),但自身抗体水平[抗核抗体(ANA)、抗双链DNA(dsDNA)]无显著性改变(P＞0．05),ALT或AST均恢复正常。结论PVB19感染在诱发SLE活动中起作用,但与SLE预后可能无关。
Objective To investigate the correlation between B19 IgM positive status and SLE severity and activity in patients with systemic lupus erythematosus (SLE) and to explore the possible relationship between PVB19 infection and SLE. Methods PVB19-VP2-IgM and IgG enzyme-linked immunosorbent assay (ELISA) kit from IBL Hamburg, Germany were used to detect the specific antibodies of serum PVB19 in 51 SLE patients and 20 normal individuals. Results Among the 51 patients with SLE, B19 IgM was detected in 11 (22%) patients. The normal control group were negative, the difference was statistically significant (P <0.01). According to B19 IgM positive / negative grouping of patients with SLE, B19 IgM positive group SLE disease activity score (SLEDAI) was significantly higher than the negative group (P <0.05); B19 IgM positive group compared with the clinical features of the negative group, There was no significant difference in alanine aminotransferase (ALT) or aspartate aminotransferase (AST) between the two groups (P> 0.05). Five patients with B19 IgM-positive SLE were followed up for 2 years. The clinical symptoms of these patients were significantly improved and the SLEDAI score was significantly decreased (P <0.05). However, the level of autoantibodies [ANA, anti-double stranded DNA dsDNA)] had no significant change (P> 0.05), ALT or AST returned to normal. Conclusion PVB19 infection plays a role in the induction of SLE, but may not be related to the prognosis of SLE.