[1]李文亮,王健楠,董翠翠,等.1 132例儿童系统性红斑狼疮患者血清抗核抗体谱表达水平与抗核抗体核型特征的分析研究[J].现代检验医学杂志,2026,41(05):1-7.[doi:10.3969/j.issn.1671-7414.2026.05.001]
　LI Wenliang,WANG Jiannan,DONG Cuicui,et al.Analysis of SerumAntinuclearAntibody Profiles andAntinuclearAntibody Nuclear Patterns in 1 132 Patients with Childhood-Onset Systemic Lupus Erythematosus[J].Journal of Modern Laboratory Medicine,2026,41(05):1-7.[doi:10.3969/j.issn.1671-7414.2026.05.001]
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1 132例儿童系统性红斑狼疮患者血清抗核抗体谱表达水平与抗核抗体核型特征的分析研究()

《现代检验医学杂志》[ISSN:/CN:]

卷:
第41卷
期数:
2026年05期
页码:
1-7
栏目:
论著
出版日期:
2026-09-15

文章信息/Info

Title:
Analysis of SerumAntinuclearAntibody Profiles andAntinuclearAntibody Nuclear Patterns in 1 132 Patients with Childhood-Onset Systemic Lupus Erythematosus
文章编号:
1671-7414 （2026） 05-001-07
作者:
李文亮a,b，王健楠a，董翠翠a，郭文伟a，范超萌a，崔小健a
（天津市儿童医院/天津大学儿童医院a.检验科；b.天津市儿童出生缺陷防治重点实验室，天津300134）
Author(s):
LI Wenlianga,b, WANG Jiannana, DONG Cuicuia, GUO Wenweia, FAN Chaomenga, CUI Xiaojiana
(a.Department of Clinical Laboratory; b.Tianjin Key Laboratory of Birth Defects for Prevention and Treatment, Tianjin Children’s Hospital/ Children’s Hospital, Tianjin University, Tianjin 300134, China)
关键词:
儿童系统性红斑狼疮;  抗核抗体;  抗核抗体谱;  可提取核抗原
分类号:
R593.24； R446.6
DOI:
10.3969/j.issn.1671-7414.2026.05.001
文献标志码:
A
摘要:
目的 通过对儿童系统性红斑狼疮 （cSLE） 患者抗核抗体 （ANA） 核型及抗核抗体谱表达情况的分析， 展现一个 较为全面的检测结果图景， 为cSLE的诊治提供参考和依据。 方法 以天津市儿童医院2020年1月~2024年12月收治的 1 132例cSLE患儿为研究对象， 按性别、 年龄、 季节、 核型、 滴度、 抗核抗体谱进行分组分析， 获得cSLE患儿ANA检测结 果的详细情况。 结果 1 132例cSLE患儿中， 女性患儿病例数为男性患儿的7.64倍； 5岁以上cSLE患儿病例数逐渐增多， 12~15岁病例数最多， 16~18岁病例数逐渐减少； 夏季cSLE患儿的就诊病例数高于其他季节。cSLE患儿ANA表现为23 种核型或核型组合， 单个核型多表现为核颗粒型、 均质型、 胞浆颗粒型和核仁型。 核颗粒型主要可提取核抗原 （ENA） 依次 为dsDNA、 SSA、 RNP、 P0、 Sm、 SSB， 均质型主要ENA依次为dsDNA、 His、 P0、 SSA、 RNP、 Sm， 胞浆颗粒型主要ENA依 次为P0、 Sm、 RNP、 dsDNA， 核仁型主要ENA依次为dsDNA、 RNP、 P0、 SSA。cSLE患儿ENA抗体阳性率由高到低排序 依次是dsDNA、 SSA、 P0、 RNP、 Sm、 His、 SSB、 CB和Jo-1， 其阳性率差异存在统计学意义 （χ2 =1 719.840， P<0.05） 。 女性患 儿的dsDNA抗体阳性率高于男性患儿 （χ2 =6.932） ， 男性患儿的SSA和RNP抗体阳性率高于女性患儿 （χ2 =5.958、 6.518） ， 差 异具有统计学意义 （均P<0.05） ； ≥10岁cSLE患儿RNP抗体阳性率相对高 （χ2 =6.271） ， <10岁患儿dsDNA抗体、 SSA抗体阳 性率相对高 （χ2 =4.782、 9.024） ， 差异具有统计学意义 （均P<0.05） 。ENA抗体全阴的cSLE患儿数量200例， 且其在ANA各 滴度中的数量相对平均； 1个、 2个ENA抗体阳性的cSLE患儿其抗核抗体分布为多种滴度， 且滴度1:1 280的患儿占比分 别为34.45%(134/389)、 48.10%(114/237)； 3个ENA抗体阳性的cSLE患儿其抗核抗体滴度多集中在1:320及以上， 且滴度 1:1 280的患儿占比为62.00%(93/150)； 4~7个ENA抗体阳性的cSLE患儿其抗核抗体滴度基本集中在1:1 280， 占比达到 60.00%(3/5)~86.76%(59/68)。 结论 12~15岁青春期女孩是儿童罹患系统性红斑狼疮的主要群体； 儿童系统性红斑狼疮的 ANA检测结果表现为高度的异质性， ANA高滴度和ENA抗体阳性数量多可作为cSLE确诊的重要参考指标； 核颗粒型中 占比最高的ENA为dsDNA。
Abstract:
Objective To present a comprehensive landscape of anti-nuclear antibody (ANA) and ANA-profile test results in childhood-onset systemic lupus erythematosus (cSLE) and to provide reference data for the diagnosis and management of the disease. Methods A total of 1 132 cSLE children admitted to Tianjin Children’s Hospital from January 2020 to December 2024 were enrolled. Gender, age, season, ANA fluorescence pattern, titre, and extractable nuclear antigen (ENA) reactivities were statistically analyzed to delineate the detailed serological characteristics of the cohort. Results Among the 1132 cSLE patients, female cases outnumbered male cases by a factor of 7.64. The number of cSLE cases gradually increased in children over 5 years of age, peaked in the 12~15 year age group, and gradually declined in the 16~18 year age group. The number of cSLE cases presenting for medical care was higher in summer than in other seasons. In this study, ANA in cSLE children exhibited 23 nuclear patterns or pattern combinations, and single patterns were predominantly nuclear speckled, homogeneous, cytoplasmic speckled, and nucleolar. The predominant ENA reactivities corresponding to the nuclear speckled pattern were, in descending order, dsDNA, SSA, RNP, P0, Sm and SSB; for the homogeneous pattern, they were dsDNA, His, P0, SSA, RNP and Sm; for the cytoplasmic speckled pattern, they were P0, Sm, RNP and dsDNA; and for the nucleolar pattern, they were dsDNA, RNP, P0 and SSA. The positive rates of ENA antibodies in cSLE children, ranked from highest to lowest, were dsDNA, SSA, P0, RNP, Sm, His, SSB, CB, and Jo-1, and the differences were statistically signi?cant (χ2 = 1 719.840, P<0.05). The positive rate of dsDNA antibodies was higher in female than in male patients (χ2 =6.932), whereas the positive rates of SSA and RNP antibodies were higher in male than in female patients (χ2 =5.958 and 6.518, respectively), and the differences were statistically signi?cant (all P<0.05). The positive rate of RNP antibodies was relatively higher in cSLE children aged ≥ 10 years (χ2 =6.271), while the positive rates of dsDNA and SSA antibodies were relatively high in children aged <10 years (χ2 =4.782 and 9.024, respectively), and the differences were statistically signi?cant (all P<0.05). A total of 200 cSLE children were negative for all ENA antibodies, and their distribution across various ANA titers was relatively even. Among cSLE children with 1 or 2 positive ENA antibodies, ANA was distributed across multiple titers, with the proportion at a titer of 1:1 280 being 34.45% (134/389) and 48.10% (114/237), respectively. Among cSLE children with 3 positive ENA antibodies, ANA titers were mostly concentrated at 1:320 and above, with 62% (93/150) at a titer of 1:1 280. Among those with 4~7 positive ENA antibodies, ANA titers were essentially concentrated at 1:1 280, accounting for 60% (3/5) to 86.76% (59/68). Conclusions Girls aged 12~15 years represent the predominant pediatric population affected by cSLE. ANA testing in cSLE exhibits marked heterogeneity. High ANA titers and a high number of positive ENA antibodies serve as key reference indicators for diagnosis. Among speckled nuclear patterns, dsDNA is the most prevalent ENA.

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备注/Memo

备注/Memo:
基金项目：天津市教委科研计划项目(2024ZX002)；天津市医学重点学科（专科）建设项目（TJYXZDXK-3-016B）。
作者简介：李文亮（1990-），男，硕士研究生，主管技师，研究方向：临床免疫学，E-mail：liwenliangjf@foxmail.com。
通讯作者：崔小健（1986-），女，硕士研究生，副主任技师，研究方向：临床免疫学，E-mail：895917667@qq.com。
更新日期/Last Update: 2026-09-15