自身抗体与狼疮活动性相关的临床研究.DOCVIP

临床医学论文-自身抗体与狼疮活动性相关的临床研究 【摘要】? 目的 探讨自身抗体中抗dsDNA抗体，ANCA，抗磷脂抗体及补体C3 、C4与系统性红斑狼疮（SLE）患者狼疮活动相关的临床研究。方法 回顾性分析88例符合美国ARA标准(1982)的SLE病人的临床情况，并对抗dsDNA抗体，补体，ANCA，抗磷脂抗体等指标与SLE活动的关系进行了探讨与分析。结果 C3下降较C4下降对诊断SLE活动更具价值，dsDNA抗体升高(尤其是30%)，对SLE活动的判断很有价值。C3下降(尤其是0.5g/L)及dsDNA抗体升高，应对病情活动加以判断，当补体C3、C4均低而dsDNA抗体升高时对诊断SLE活动价值最大。64例活动期患者ANCA阳性率略高于非活动期患者，检测SLE患者的ANCA可能有助于判断该疾病的活动性。抗磷脂抗体对病情活动监测有意义，联合测定对于SLE的早期诊断、监测、治疗更有意义。结论 血清中自身抗体：ds-DNA抗体、ANCA、抗磷脂抗体及补体与系统性红斑狼疮病情活动性高度相关。 【关键词】? 红斑狼疮；抗dsDNA抗体；补体；抗中性粒细胞胞浆抗体；抗磷脂抗体 ??? 【Abstract】 Objective To study the relativity between the level of complement、anti - dsDNA、ANCA、anti-phospholipid antibody and systemic lupus erythematosus activity.Methods We analysed 88 patients with systemic lupus erythematosus(SLE) and discussed the relation between the level of anti-dsDNA,complement,ANCA, anti-phospholipid antibody and disease activity.Results Lower serum level of C3 was more valuable than that of C4 in SLE activety. Higher serum level of anti-dsDNA (30%) was valuable in SLE activity. Lower level of C3 and higher level of anti-dsDNA were used as a predictor of disease activity.Lower level of complement (C3、C4)and higher level of anti-dsDNA was the most valuable to activity in SLE.The 64 SLE patients with ANCA had relatively higher than the non-activity SLE patients,detecting ANCA in the SLE patients may help to judge the activity of this disease.Anti-phospholipid antibody has value in monitoring disease development .The combined detecting contributed to early diagnosis of SLE,monitoring disease development and the therapeutic effect.Conclusion The level of complement,anti-dsDNA,ANCA,anti-phospholipid antibody were associated with systemic lupus erythematosus activity. ??? 【Key words】 lupus erythematosus; anti-ds DNA antibody; complement;antinutrophil cytoplasmic antibody;anti-phospholipid antibody ??? 系统性红斑狼疮(systemic lupus erythematosus,SLE)是一种可累及全身各个脏器和组织的自身免疫性疾病。对狼疮患者免疫系统改变的研究对于SLE的诊断及疗效判定具有很重要的作用。目前作为狼疮活动性判定的免疫学指标有多种，临床医师通常也参考特异性较高的检查结果来评估狼疮是否活动。而SLE的病情