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目的探讨双链DNA抗体(dsDNA抗体)在常见自身免疫性疾病中的检出情况,评估不同方法联合检测系统性红斑狼疮(SLE)患者血清中dsDNA抗体的性能。方法使用ELISA法(ELISA1、ELISA2)和间接免疫荧光(IIF)法同时检测300例SLE和495例非SLE自身免疫疾病患者,以及300例健康体检者血清dsDNA抗体,分析单独和联合使用不同方法检测dsDNA抗体对SLE的诊断效能。结果 ELISA1、ELISA2和IIF在SLE患者中的检出率分别为42.3%、35.3%和38.0%,在非SLE自身免疫性疾病患者中最高检出率为1.2%,在健康体检人群中最高为0.3%。在SLE人群,3种方法中ELISA1和ELISA2法,ELISA1和IIF法,以及ELISA2和IIF法联合Kappa值分别为0.672、0.398和0.512(P<0.05)。而只有ELISA1和ELISA2间的检测率差异有统计学意义(P=0.003)。ELISA1、ELISA2和IIF法检测dsDNA抗体的受试者工作特征曲线下面积(AUC)分别为0.708、0.672和0.687;ELISA1和IIF法的联合检出率最高为54.7%,AUC为0.764;3种方法同时检测,任何1种方法阳性即判断为阳性时,检出率为57.7%,AUC为0.781。结论联合使用ELISA法和IIF法,可以明显提升dsDNA抗体在SLE中的检出率。
Objective To investigate the detection of double-stranded DNA antibody (dsDNA antibody) in common autoimmune diseases and to evaluate the performance of different methods to detect the serum dsDNA antibody in patients with systemic lupus erythematosus (SLE). Methods Serum dsDNA antibodies of 300 patients with SLE and 495 non-SLE autoimmune diseases and 300 healthy controls were detected simultaneously by ELISA (ELISA1, ELISA2) and indirect immunofluorescence (IIF), and the results were analyzed separately and in combination with different methods Diagnostic efficacy of dsDNA antibodies on SLE. Results The positive rates of ELISA1, ELISA2 and IIF in SLE patients were 42.3%, 35.3% and 38.0% respectively. The highest detection rate was 1.2% in patients with non-SLE autoimmune diseases and 0.3 %. In the SLE population, ELISA1 and ELISA2, ELISA1 and IIF in the three methods, and Kappa values for ELISA2 and IIF were 0.672, 0.398 and 0.512, respectively (P <0.05). However, only the difference between ELISA1 and ELISA2 was statistically significant (P = 0.003). The area under the receiver operating characteristic curve (AUC) of ELISA, ELISA2 and IIF were 0.708,0.672 and 0.687 respectively; the highest detection rate of ELISA1 and IIF was 54.7% and the AUC was 0.764; three methods At the same time test, any one of the positive methods that is judged as positive, the detection rate was 57.7%, AUC was 0.781. Conclusions Combination of ELISA and IIF can obviously improve the detection rate of dsDNA antibody in SLE.