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目的探讨抗核小体抗体(AnuA)水平与红斑狼疮(LE)疾病亚型及其治疗前后的关系。方法采用酶联免疫吸附法(ELISA)测定31例系统性红斑狼疮(SLE)、26例亚急性皮肤型红斑狼疮(SCLE)、7例盘状红斑狼疮(DLE)、6例硬皮病、5例皮肌炎患者和30例健康人血清AnuA水平,根据SLE患者临床表现及实验室检查指标,进行SLE疾病活动指数(SLEDAI)评分,并对LE患者AnuA进行治疗前后的比较。结果SLE患者血清AnuA水平与SCLE、DLE、硬皮病、皮肌炎患者和正常对照组相比显著增高(P均<0.01);SLE活动期患者血清AnuA水平与SLE非活动期相比显著增高(P均<0.01);SCLE、DLE、硬皮病患者血清AnuA水平两两相比差异无统计学意义(P>0.05),与皮肌炎、正常对照组相比差异有统计学意义(P<0.05);皮肌炎患者和正常人对照组相比差异无统计学意义(P>0.05)。AnuA水平与SLEDAI有明显相关性(P=0.015,r=0.441),SLE患者治疗后血清AnuA水平与治疗前相比明显降低(P<0.05)。结论AnuA水平与LE的亚型和是否活动有相关性,对诊断疾病、监测病情活动和判断疗效有意义。
Objective To investigate the relationship between anti-nucleosome antibody (AnuA) levels and the subtypes of lupus erythematosus (LE) and their therapeutic efficacy before and after treatment. Methods Thirty - one patients with systemic lupus erythematosus (SLE), 26 patients with subacute cutaneous lupus erythematosus (SCLE), 7 patients with discoid lupus erythematosus (DLE), 6 patients with scleroderma and 5 patients with scleroderma were enrolled in this study by enzyme - linked immunosorbent assay (ELISA) The serum AnuA levels of patients with dermatomyositis and 30 healthy people were measured. The SLE disease activity index (SLEDAI) was scored according to the clinical manifestations and laboratory tests of SLE patients. AnuA was compared before and after treatment. Results The level of serum AnuA in patients with SLE was significantly higher than that in patients with SCLE, DLE, scleroderma and dermatomyositis (all P <0.01). The level of serum AnuA in SLE patients was significantly higher than that in SLE patients (P <0.01). There was no significant difference in serum AnuA level between SCLE and DLE patients and scleroderma patients (P> 0.05), but there was significant difference compared with dermatomyositis and normal control group (P <0.05). There was no significant difference between the dermatomyositis patients and the normal controls (P> 0.05). The level of AnuA was significantly correlated with SLEDAI (P = 0.015, r = 0.441). The level of serum AnuA in patients with SLE was significantly lower than that before treatment (P <0.05). Conclusion The level of AnuA is correlated with the subtypes of LE and whether it is active or not, which is significant for diagnosing disease, monitoring disease activity and judging the curative effect.