Diagnostic Value Of ANAs,APAs And VitD In SLE And Its Correlation Analysis

SLE is an autoimmune disease characterized by multiple system and organ dysfunction.The clinical manifestations of SLE are complex and diverse,and there are many autoantibodies of immune activity in the serum of patients,which can damage the function of multiple parts and can affect the skin,joints,blood,central nervous system,digestive system,circulatory system,respiratory system and so on.Women of childbearing age is a high incidence of SLE,in China,the ratio of male to female is about 1:7-9,the prevalence rate is about 0.07%.The pathogenesis of SLE is unknown,it is generally believed that genetic factors,in a certain environmental factors or(and)the impact of sex hormones,so that the abnormal immune response is activated and producing a large number of immune complexes and pathogenic autoantibodies attack their organs and cause tissue damage.It is also found that serum VitD participates in the process of immune regulation,which helps to maintain the stability of immune environment.Therefore,the deficiency of VitD may lead to the disorder of immune environment,and then lead to a series of autoimmune diseases.A number of recent studies have shown that levels of VitD in SLE patients are generally lower than normal values,suggesting that VitD may be associated with the pathogenesis of SLE disease.Therefore,autoantibodies and VitD detection of laboratory for the development of SLE disease is particularly important.Currently,autoantibodies include ANA and ANAs that target most of the nuclear components,ACA use the negative charge and beta 2 glycoprotein use the phospholipid binding protein as a target antigen of APA.The detection of these autoantibodies and VitD have attracted much attention in the study of SLE disease,and the pathogenesis of SLE has become a hot topic.This paper is divided into three parts,which states the study of SLE and ANAs,APAs,VitD.Part OneDetection and clinical significance of antinuclear antibodies in systemic lupus erythematosusObjective To investigate ANA and ANAs in the value of diagnosis of SLE.Method Seting the SLE group,other autoimmune diseases group and healthy control group,using IIF,IBT)to detect the serum levels of ANA and ANAs in the three groups and do the performance evaluation of single and multiple indexes for SLE diagnosis.Result1.The ANA in the SLE group had a higher positive rate.2.The positive rate of detection of ANAs in SLE group were significantly higher than those in non SLE group and healthy control group,in addition to anti SCL-70 antibody,anti PM-Scl antibody,anti JO-1 antibody and anti CENP,the differences were statistically significant(P<0.05).3.The performance evaluation of single index of detecting SLE:the highest sensitivity was ANA,the value of anti Sm antibody in diagnosis of SLE is the greatest.4.The combination of multiple indicators can increase the sensitivity of SLE,and the specificity can decrease.Conclusion:1?The anti Scl-70,PM-Scl,Jo-1,and CENP antibody have no significance in the diagnosis of SLE.2?ANA combined with ANAs has important clinical value in the diagnosis of SLE.3?Anti Sm antibody,anti ds-DNA antibody,AnuA and AHA have higher sensitivity to SLE,combined with ANA detection can improve the detection rate of SLE.Part TwoThe detection and clinical application of antiphospholipid antibodies in systemic lupus erythematosusObjective To evaluate the clinical value of six kinds of anti cardiolipin antibody(ACA),anti ?2-glycoprotein 1(?2-GP-1)antibody and lupus anticoagulant(LA)of antiphospholipid antibodies(APAs)in patients with systemic lupus erythematosus(SLE).Methods Using enzyme-linked immunosorbent assay(ELISA)and diluted viper venom cephalin time method(dRVVT)to detect six subtypes of ACA,anti?2-GP-1 antibody and LA in 152 SLE patients,132 patients with antiphospholipid syndrome(APS)patients,130 patients with pathological pregnancy,except SLE in 126 patients with other autoimmune diseases and 100 healthy people respectively.Results In the SLE except ACA and anti ?2-GP-1 antibody,the positive rate of other serological indicators were higher than the other four groups,the difference was statistically significant(P<0.05).The sensitivity of IgG type ACA are the highest in five groups when detect the four kinds of disease,and SLE>APS>pathological pregnancy>non SLE group,and the specificity of anti IgA type and was the biggest in the four disease groups.Conclusion1?APAs are most closely related to SLE,IgG type of ACL is a good screening index of SLE2?he positive of APAs can occur in a variety of diseases,there is a certain relationship with each other,anti ?2-GP-1 antibody of IgG type is the most related to clinical disease,and ACA and anti beta 2-GP-1 antibodies of IgA are less valuable in diagnosing diseasePart ThreeResearch on the relationship between serum vitamin D level and systemic lupus erythematosusObjective:Through detecting the level of 25-OH-VD of SLE in patients and healthy control group,and analyzing the correlation between clinical and laboratory parameters of patients with SLE,in order to investigate the role of VitD of SLE.Methods:1?The subjects were divided into SLE group and healthy control group.The levels of 25-OH-VD in the two groups were measured by chemiluminescence method.The serum levels of VitD were compared among the SLE,non SLE and the healthy control group.2?Consulting the relevant cases and selecting the firstly diagnosed patients,collecting titers of ANA and anti ds-DNA antibody,SLEDAI,APA and other related laboratory indexes.Comparing the correlation of levels of serum VitD with ANA,anti ds-DNA antibody titer,score index of SLE and APA.Results:1?The serum levels of 25-OH-VD in the experimental group and the healthy control group were significantly different,P<0.05.2?The level of 25-OH-VD was negatively correlated with ANA titer,APA and SLEDAI,and the difference was statistically significant,P<0.05,but has no significant correlation with anti ds-DNA antibody titer,P>0.05.Conclusion:1?The level of 25-OH-VD in the experimental group was significantly lower than those in the control group,suggesting that the level of VitD may be a protective factor of SLE.2?The level of 25-OH-VD was correlated with the titer of ANA,APA and SLEDAI,and could be used as a serological marker for monitoring SLE.