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目的了解Coombs实验阳性和阴性系统性红斑狼疮(SLE)患者之间ANA、ACA、ENA、抗dsDNA抗体检测结果差异,分析Coombs实验分型与自身抗体表达的关系。方法收集86例Coombs实验阳性SLE患者血清,采用间接免疫荧光法检测ANA,滴金免疫渗滤法检测ACA、ENA和抗dsDNA抗体,以81例Coombs实验阴性SLE患者作为对照组。结果 Coombs实验阳性SLE患者组抗dsDNA抗体和抗SSB抗体阳性率显著高于Coombs实验阴性SLE患者组(χ2=5.208,P<0.05;χ2=5.012,P<0.05)。Coombs实验各分型组比较,IgG+C3d型组和C3d型组之间3种抗体阳性率存在显著性差异,分别是抗Sm抗体(χ2=6.737,P<0.01)、抗u1RNP抗体(χ2=7.851,P<0.01)和抗SSA抗体(χ2=10.393,P<0.01)。C3d型组与IgG型组之间2种抗体阳性率存在显著性差异,分别是抗u1RNP抗体(χ2=10.776,P<0.01)和抗SSA抗体(χ2=4.010,P<0.05)。结论 Coombs实验阳性和阴性SLE患者间及Coombs实验各分型组间自身抗体表达存在差异。
Objective To investigate the difference of ANA, ACA, ENA and anti-dsDNA antibody between Coombs positive and negative patients with systemic lupus erythematosus (SLE) and to analyze the relationship between Coombs experimental typing and autoantibody expression. Methods Sera from 86 SLE patients with Coombs test were collected. ANA was detected by indirect immunofluorescence assay. ACA, ENA and anti-dsDNA antibodies were detected by immunogold filtration assay. 81 patients with SLE with Coombs test were used as control group. Results The positive rates of anti-dsDNA antibody and anti-SSB antibody in Coombs positive SLE patients were significantly higher than those in Coombs negative SLE patients (χ2 = 5.208, P <0.05; χ2 = 5.012, P <0.05). There were significant differences in the positive rates of the three antibodies between IgG + C3d group and C3d group (χ2 = 6.737, P <0.01), anti-u1RNP antibody (χ2 = 7.851, P <0.01) and anti-SSA antibody (χ2 = 10.393, P <0.01). There were significant differences in the positive rates of the two antibodies between the C3d group and the IgG group, which were anti-u1RNP antibody (χ2 = 10.776, P <0.01) and anti-SSA antibody (χ2 = 4.010, P <0.05). Conclusion The autoantibodies expressed in Coombs positive and negative SLE patients and in Coombs experimental patients were different.