中华皮肤科杂志 ›› 2008, Vol. 41 ›› Issue (1): 43-45.

• 论著 • 上一篇    下一篇

SLE患者血清抗中性粒细胞胞质抗体的临床意义

方雪晖1,苏虹2,叶冬青3,等4   

  1. 1. 合肥　安徽医科大学公共卫生学院流行病与卫生统计学系
    2. 合肥安徽医科大学流行病学教研室
    3. 合肥市梅山路81号《中华疾病控制杂志》编辑部
    4. 湖北省中山医院整形美容外科
  • 收稿日期:2007-04-30 修回日期:2007-09-03 发布日期:2008-01-31
  • 通讯作者: 方雪晖
  • 基金资助:
    国家自然科学基金资助项目（30571608），安徽省自然科学基金资助项目（070413109）

  • Received:2007-04-30 Revised:2007-09-03 Published:2008-01-31

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摘要： 目的 探讨抗中性粒细胞胞质抗体（ANCA）与SLE的关系及其临床意义。方法 选择60例SLE新发病例和60例正常人对照，用ELISA法将其分为ANCA阳性和阴性组，调查表收集所有患者的一般情况、临床表现及实验室检查。结果 60例SLE新发病例中ANCA阳性率为33.3%，对照组中ANCA阳性率为3.3%，两组差异具有统计学意义（P < 0.001）。SLE活动组ANCA阳性率（84.62%）显著高于非活动组（19.15%，P < 0.01）。ANCA阳性组中神经系统紊乱、心肌炎、肾损害、浆膜炎、抗dsDNA抗体阳性、抗Sm抗体阳性、γ-球蛋白升高、补体下降以及血清IgG升高的发生率明显高于阴性组（P < 0.05）。ANCA阳性组中，SLE疾病活动指数评分（SLE-DAI）（24.40 ± 10.16）及ESR（84.45 ± 29.03）显著高于阴性组的SLE-DAI（11.30 ± 6.07）及ESR（47.07 ± 26.31）（P < 0.05）。狼疮性肾炎（LN）组ANCA阳性率（46.7%）显著高于非狼疮性肾炎（非LN）的SLE组（21.9%，P < 0.05）。结论 ANCA可作为评价SLE疾病活动及鉴别LN与非LN的一个参考指标。

关键词: 狼疮肾炎, 抗体，抗中性白细胞胞质, 酶联免疫吸附测定

Abstract: Objective To study the significance of antineutrophil cytoplasmic antibodies （ANCA） and its relationship with systemic lupus erythematosus （SLE）. Methods Sixty patients with SLE and sixty normal controls were enrolled in this study, and divided into ANCA-positive and ANCA-negative groups based on ELISA results. The data on patients' general state of health, clinical manifestations and laboratory examination results were collected by questionnaire or medical records. Results The positive rate of ANCA was significantly higher in SLE group than in normal controls （33.3% vs 3.3%, P < 0.001）, and in active SLE patients than in non-active SLE patients（84.62% vs 19.15%, P < 0.01）. Compared with patients negative for ANCA, the ANCA-positive patients had a significantly higher incidence of nervous system disorders, myocarditis, renal damage and serositis, decrease of serum complement level, increase of serum IgG level, and a higher positive rate of anti-dsDNA antibody, anti-Sm antibody and γ-globulin （all P < 0.05）. The SLE disease activity index and ESR value were significantly higher in ANCA-positive patients than those in ANCA-negative patients （24.40 ± 10.16 vs 11.30 ± 6.07, 84.45 ± 29.03 vs 47.07 ± 26.31, respectively, both P < 0.05）. The patients with lupus nephritis had a significantly higher positive rate of ANCA than that without nephritis （46.7% vs 21.9%, P < 0.05）. Conclusion ANCA may serve as a parameter for the assessment of disease activity of SLE and differentiation of SLE with lupus nephritis from those without.