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目的比较抗核小体抗体(AnuA)单独及与抗核抗体(ANA)、抗Sm抗体和抗双链DNA(dsDNA)抗体联合检测对儿童系统性红斑狼疮(JSLE)与成人SLE的诊断价值;探讨AnuA与JSLE和成人SLE的临床特点及SLE疾病活动指数(SLEDAI)评分的相关性并进行比校分析。方法选取141例JSLE及165例成人SLE患者,56例非JSLE及46例成人非SLE的疾病对照组,采用酶联免疫吸附法(ELISA)检测血清AnuA;收集JSLE和成人SLE患者同期临床资料及相关实验室检查结果,进行SLEDAI评分,分析JSLE和成人SLE患者AnuA与上述指标的相关性并进行比较分析。结果 JSLE与成人SLE发病性别组成差异无统计学意义。AnuA对JSLE的敏感度(74.47%)高于成人SLE组(59.39%),二者比较差异有统计学意义(P<0.05)。JSLE组AnuA与抗dsDNA抗体及抗Sm抗体联合检测敏感度分别为84.68%和83.47%,高于成人SLE组72.05%和65.99%,差异均有统计学意义。JSLE、成人SLE组AnuA与SLEDAI评分均呈正相关(r=0.239,P=0.032;r=0.125,P=0.014)。结论Aun A单独或与抗dsDNA抗体和抗Sm抗体联合检测,对JSLE诊断的敏感度均较成人SLE高。AunA与2组疾病活动度相关,为JSLE、成人SLE的诊断及疾病活动度的评估提供了又一临床应用价值。
Objective To compare the diagnostic value of AnuA alone and in combination with anti-nuclear antibody (ANA), anti-Sm antibody and anti-dsDNA antibody in the diagnosis of childhood systemic lupus erythematosus (JSLE) and adult SLE. To explore the correlation between AnuA and clinical features of SLE and adult SLE and SLE disease activity index (SLEDAI) score and carry out comparative school analysis. Methods 141 cases of JSLE and 165 cases of adult SLE patients, 56 cases of non-JSLE and 46 cases of adult non-SLE control group were collected. Serum AnuA was detected by enzyme-linked immunosorbent assay (ELISA). The clinical data of JSLE and adult SLE patients were collected, Related laboratory test results, SLEDAI score, analysis of JSLE and adult SLE patients AnuA correlation with the above indicators and comparative analysis. Results There was no significant difference in sex composition between JSLE and adult SLE. The sensitivity of AnuA to JSLE (74.47%) was higher than that of adult SLE (59.39%), the difference was statistically significant (P <0.05). The detection sensitivity of AnuA in combination with anti-dsDNA antibody and anti-Sm antibody in JSLE group was 84.68% and 83.47% respectively, higher than that in adult SLE group (72.05% and 65.99%, respectively). The differences were statistically significant. There was a positive correlation between AnuA and SLEDAI scores in JSLE and adult SLE patients (r = 0.239, P = 0.032; r = 0.125, P = 0.014). Conclusion Aun A alone or in combination with anti-dsDNA antibody and anti-Sm antibody detection, the sensitivity of JSLE diagnosis than adult SLE. AunA is related to the activity of the two groups, which provides another clinical application value for the diagnosis of JSLE and adult SLE.