摘要
目的探讨系统性红斑狼疮(SLE)患者抗双链DNA(dsDNA)抗体阳性和抗史密斯(Sm)抗体阳性的临床特点和实验室指标检测结果的差异。方法回顾性分析2012年7月至2019年7月四川大学华西医院收治并同时检测抗dsDNA抗体和抗Sm抗体的SLE患者的相关信息,将抗体阳性的患者分成抗dsDNA抗体阳性组(1534例)、抗Sm抗体阳性组(494例)和双抗体阳性组(432例),分析3组患者的临床特点和实验室检测结果的差异。结果抗Sm抗体阳性组和双抗体阳性组患者面部红斑、光过敏、雷诺现象、皮疹和肺部疾病的阳性率高于抗dsDNA抗体阳性组(P<0.05),抗dsDNA抗体阳性组患者发热和水肿的阳性率高于抗Sm抗体阳性组(P<0.05),抗dsDNA抗体阳性组和双抗体阳性组肾脏疾病的阳性率高于抗Sm抗体阳性组(P<0.05)。抗dsDNA抗体阳性组的红细胞、血红蛋白、血小板、白细胞水平低于抗Sm抗体阳性组(P<0.05)。抗dsDNA抗体阳性组和双抗体阳性组的尿素氮、肌酐、胱抑素C水平高于抗Sm抗体阳性组(P<0.05),而肾小球滤过率低于抗Sm抗体阳性组。抗dsDNA抗体阳性组和双抗体阳性组的总胆红素、直接胆红素、间接胆红素、总蛋白、清蛋白水平低于抗Sm抗体阳性组(P<0.05)。结论抗Sm抗体阳性的SLE患者发生皮肤损害、肺部疾病和肝损害的风险较高,而抗dsDNA抗体阳性SLE患者发生肾脏疾病和血液系统疾病的风险较高。临床上应重视SLE患者的诊治过程,尽早干预,延缓病程快速进展,阻止病情恶化。
Objective To investigate the differences of clinical characteristics and laboratory index results of anti-double stranded DNA(dsDNA)antibody positive and anti-Smith(Sm)antibody positive in patients with systemic lupus erythematosus(SLE).Methods Retrospective analysis was performed on SLE patients admitted to west China hospital,Sichuan University from July 2012 to July 2019 and tested both anti-dsDNA antibody and anti-Sm antibody,the patients with positive antibodies were divided into anti-dsDNA antibody positive group(1534 cases),anti-Sm antibody positive group(494 cases)and double antibody positive group(432 cases).The clinical characteristics and laboratory test results of the three groups of patients were analyzed.Results The positive rates of facial erythema,photoallergy,Raynaud′s phenomenon,rash and lung disease in the anti-Sm antibody positive group and the double antibody positive group were higher than those in the anti-dsDNA antibody positive group(P<0.05),the positive rates of fever and edema in the anti-dsDNA antibody positive group were higher than those in the anti-Sm antibody positive group(P<0.05),and the positive rates of kidney disease in the anti-dsDNA antibody positive group and the double antibody positive group were higher than those in the anti-Sm group(P<0.05).The levels of red blood cell,hemoglobin,blood platelet and white blood cell in the anti-dsDNA antibody positive group were lower than those in the anti-Sm antibody positive group(P<0.05).The levels of urea nitrogen,creatinine and cystatin C in the anti-dsDNA antibody positive group and the double antibody positive group were higher than those in the anti-Sm antibody positive group(P<0.05),while estimated glomerular filtration rates were lower than the anti-Sm antibody positive group.The levels of total bilirubin,direct bilirubin,indirect bilirubin,total protein and albumin in the anti-dsDNA antibody positive group and the double antibody positive group were lower than those in the anti-Sm antibody positive group(P<0.05).Conclusion SLE patients with positive anti-Sm antibody have a higher risk of skin damage,lung disease and liver damage.However,SLE patients with anti-dsDNA antibody positive have a higher risk of kidney disease and blood system disease.Clinically,the diagnosis and treatment process of SLE patients should be paid attention to,as early as possible to give intervention,delay the rapid progress of the disease and prevent the deterioration of the disease.
作者
苏向珠
梅丽春
翟建昭
武永康
SU Xiangzhu;MEI Lichun;ZHAI Jianzhao;WU Yongkang(Department of Laboratory Medicine,West China Hospital,Sichuan University,Chengdu,Sichuan 610041,China;Department of Clinical Laboratory,the First People′s Hospital of Zhaotong,Zhaotong,Yunnan 657000,China)
出处
《国际检验医学杂志》
CAS
2020年第23期2862-2866,共5页
International Journal of Laboratory Medicine
基金
四川省成都市科技项目(2019-GH02-00006-HZ)
四川大学华西医院学科卓越发展1·3·5工程项目(ZYJC18042)。
