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目的分析抗细胞膜DNA(m DNA)抗体与其他自身抗体的相关性,评价其对系统性红斑狼疮(SLE)的诊断意义。方法收集2015年1月-8月就诊的254例自身免疫性疾病患者血清,包括SLE 106例,类风湿关节炎(RA)80例,混合性结缔组织病(MCTD)32例,干燥综合征(SS)29例,多发性肌炎/皮肌炎(PM/DM)7例;另再收集20例正常对照者血清。分别用间接荧光免疫法检测抗m DNA抗体、抗双链DNA(ds DNA)抗体、抗核抗体(ANA)及抗角蛋白抗体(AKA),酶联免疫吸附测定法检测抗环瓜氨酸肽(CCP)抗体,速率散射比浊法检测类风湿因子(RF),免疫印迹法检测抗Sm抗体。结果抗m DNA抗体在SLE中的阳性率为72.6%(77/106),显著高于RA[5.0%(4/80)]、MCTD[18.7%(6/32)]、SS[14.7%(4/29)]、PM/DM[0.0%(0/7)]以及健康对照组[0.0%(0/20)],差异有统计学意义(P<0.001);抗m DNA抗体对SLE诊断的灵敏度、特异度和诊断效率分别为72.6%、91.7%和84.3%;抗m DNA抗体与ANA、抗ds DNA抗体及抗Sm抗体显著相关(P<0.001),与抗CCP抗体、AKA及RF无相关性(P>0.05)。结论抗m DNA抗体与SLE相关自身抗体密切相关,对SLE诊断具有高度灵敏度和特异度。
Objective To analyze the relationship between anti-cell membrane DNA (m DNA) antibodies and other autoantibodies and evaluate their diagnostic value for systemic lupus erythematosus (SLE). Methods A total of 254 patients with autoimmune diseases from January to August in 2015 were collected, including 106 cases of SLE, 80 cases of rheumatoid arthritis (RA), 32 cases of mixed connective tissue disease (MCTD), 32 cases of Sjogren’s syndrome SS) 29 cases, polymyositis / dermatomyositis (PM / DM) in 7 cases; another 20 cases of normal control serum collected. The anti-m DNA antibody, anti-ds DNA antibody, antinuclear antibody (ANA) and anti-keratin antibody (AKA) were detected by indirect fluorescent immunosorbent assay (ELISA) (CCP) antibody, rheumatoid factor (RF) by rate nephelometry and anti-Sm antibody by Western blot. Results The positive rate of anti-m DNA antibody in SLE was 72.6% (77/106), significantly higher than that in RA [5.0% (4/80)], MCTD [18.7% (6/32)], SS [14.7% 4/29)], PM / DM [0.0% (0/7)] and healthy control group [0.0% (0/20)], the difference was statistically significant The sensitivity, specificity and diagnostic efficiency were 72.6%, 91.7% and 84.3% respectively. Anti-m DNA antibody was significantly associated with ANA, anti-ds DNA and anti-Sm antibodies No correlation (P> 0.05). Conclusion Anti-m DNA antibody is closely related to SLE-related autoantibodies and is highly sensitive and specific for the diagnosis of SLE.