抗双链DNA抗体四种检测方法的比较及临床应用

目的比较短膜虫间接免疫荧光法（CLIFT）、酶免疫印迹法（LIA）、胶体金快速斑点法（DIGFA）、酶联免疫吸附法（ELISA）检测抗双链DNA（ds-DNA）抗体的敏感度和特异度,探讨4种方法在检测抗双链DNA抗体的临床应用价值,寻找对临床最有价值的检测方法。方法用4种方法检测59例系统性红斑狼疮（SLE）患者,50例健康体检者血清中抗ds-DNA抗体,比较各种检测方法的敏感度、特异度和符合率。结果 CLIFT法、胶体金快速斑点法在SLE中的检出率分别为52.5%、44.1%、66.1%、57.6%,均明显高于健康对照组,差异有统计学意义（P〈0.01）;CLIFT法与其他三种方法之间没有显著的统计学差异（P〉0.05）,仅是方法学上的差异。结论 4种方法检测抗ds-DNA抗体均具有很高特异度,但敏感度略有差异,胶体金快速斑点法敏感度最高,检测方法操作方便适用于临床快速筛查,免疫荧光法的特异度高,可以用于临床确认试验方法。

Comparison of four anti-ds-DNA antibody detection methods and clinical application

Objective To compare the sensitivity and specificity degree of crithidia luciliae immunofluorescence test（CLIFT）,line immunoassays（LIA）,dot immunogold filtration assay（DIGFA） and enzyme linked immunosorbent assay（ELISA） in determining anti-ds-DNA antibody and to investigate the diagnostic value of the four detection methods in clinical application.Methods Totally 59 cases of systemic lupus erythematosus（SLE） and 50 healthy controls were selected.The serum anti-ds-DNA antibody was detected with four methods and their sensitivities,specificities and correlations were compared respectively.Results The detection rates of CLIFT,LIA,DIGFA and ELISA in SLE were 52.5%,44.1%,66.1% and 57.6% respectively,higher than those of healthy controls（P0.01）.No statistical difference was found between CLIFT and other three methods（P0.05）,but the methodology of CLIFT was different.Conclusion The four methods all have high specificity in diagnosing SLE,however,their sensitivities are slightly different.DIGFA has the highest sensitivity and is easily manipulated,suitable for the quick clinical screening.CLIFT has the highest specificity and can be used for the clinical confirmation.