[1]刘欢欢,潘发明,陈礼文.抗核小体抗体和抗 Sm 抗体鉴别诊断系统性红斑狼疮的 Meta 分析[J].现代检验医学杂志,2021,36(03):1-6.[doi:10.3969/j.issn.1671-7414.2021.03.001]
　LIU Huan-huan,PAN Fa-ming,CHEN Wen-li.Value of Antinucleosome Antibody and Anti-Sm Antibody in the DifferentialDiagnosis of Systemic Lupus Erythematosus：A Meta-Analysis[J].Journal of Modern Laboratory Medicine,2021,36(03):1-6.[doi:10.3969/j.issn.1671-7414.2021.03.001]
点击复制

抗核小体抗体和抗 Sm 抗体鉴别诊断系统性红斑狼疮的 Meta 分析()
分享到：

《现代检验医学杂志》[ISSN:/CN:]

卷:
第36卷
期数:
2021年03期
页码:
1-6
栏目:
论　著
出版日期:
2021-05-31

文章信息/Info

Title:
Value of Antinucleosome Antibody and Anti-Sm Antibody in the DifferentialDiagnosis of Systemic Lupus Erythematosus：A Meta-Analysis
文章编号:
1671-7414（2021）03-001-07
作者:
刘欢欢; 潘发明; 陈礼文
（1. 安徽医科大学第二附属医院检验科，合肥 230032;2. 安徽医科大学公共卫生学院，合肥 230032）
Author(s):
LIU Huan-huan1; PAN Fa-ming2; CHEN Wen-li1
(1.Department of Clinical Laboratory,the Second Affiliated Hospital of AnhuiMedical University,Hefei 230032,China; 2.School of Public Health, Anhui Medical University, Hefei 230032,China)
关键词:
抗核小体抗体; 抗 Sm 抗体; 系统性红斑狼疮; 自身免疫病; meta 分析
分类号:
R593.241；R392.11
DOI:
10.3969/j.issn.1671-7414.2021.03.001
文献标志码:
A
摘要:
目的　系统评价抗核小体抗体（antinucleosome antibody,ANuA）和抗 Sm 抗体（anti-Smith）在鉴别诊断系统性红斑狼疮（systemic lupus erythematosus，SLE）和其他自身免疫病中的临床价值。方法　系统检索中国知网（CNKI），CBM，PubMed 和 EMBASE 数据库，检索时间为建库至 2020 年 6 月 30 日，纳入以 ANuA 和抗 Sm 抗体两项指标鉴别诊断 SLE 与其他自身免疫病的研究，并计算敏感度、特异度、阳性比值比、阴性比值比及诊断比值比，此外，绘制汇总受试者工作曲线（SROC）并计算曲线下面积（AUC），主要分析采用 Stata15.0 软件进行。结果　共纳入 13 篇诊断性相关文献（实验组 2 068 例，对照组 1 259 例）。ANuA 和抗 Sm 抗体的合并敏感度分别为 0.60(95%CI:0.48~0.71) 和0.33(95%CI:0.25~0.42)，合并特异度分别为 0.97(95%CI:0.95~0.98）和 0.98（95%CI:0.97~0.99），合并诊断比值比分别为44.40(95%CI:21.45~91.90) 和 19.30(95%CI:10.97~33.97)；SROC 曲线下面积分别为 0.96( 95CI%:0.94~0.97 ) 和 0.87 (95CI%:0.83~0.89 )。结论 ANuA 诊断 SLE 的敏感度高于抗 Sm 抗体，具有较大的临床应用价值。

参考文献/References:

[1] ARINGER M,SCHNEIDER M. Systemic lupus erythematosus[J]. Deutsche Medizinische Wochenschrift,2016, 141(8): 537-543.
[2] 邢红宇 , 高荣海，邵运禄 , 等 . 抗细胞膜 DNA 抗体联合抗核抗体检测在系统性红斑狼疮诊断中的价值[J]. 中国现代医学杂志 , 2019, 29(17):48-53. XING Hongyu,GAO Ronghai,SHAO Yunlu, et al.Diagnostic value of anti-cell membrane DNA antibodycombined with antinuclear antibody for systemiclupus erythematosus [J]. China Journal of ModernMedicine,2019. 29(17):48-53.
[3] HOCHBERG M C. Updating the American Collegeof Rheumatology revised criteria for the classification of systemic lupus erythematosus [J]. ArthritisRheum,1997, 40(9):1725.
[4] 晁亚妮 , 盖玉萍 , 赵咏梅 , 等 . 系统性红斑狼疮患者血清抗核抗体免疫荧光核型与特异性抗体谱的相关分析 [J]. 现代检验医学杂志 ,2020,35(5):41-44,61. CHAO Yani, GAI Yuping, ZHAO Yongmei, et al.Analysis of serum antinuclear antibody fluorescencepatterns and specific antibodies profile in patients with systemic lupus erythematosus[J].Journal of ModernLaboratory Medicine,2020,35(5):41-44,61.
[5] HISSARIA P, BROADFOOT A, BAUMGART K W.Revisiting the antinuclear antibody test with emphasison a new pattern: anti-DFS70 antibody[J]. The MedicalJournal of Australia, 2019, 210(2):69-71.
[6] WHITING P,RUTJES A W, REITSMA J B, et al.The development of QUADAS: a tool for the qualityassessment of studies of diagnostic accuracy includedin systematic reviews[J]. BMC Medical ResearchMethodology, 2003, 3(1):25.
[7] DEVILL? W L, BUNTINX F, BOUTER L M, et al.Conducting systematic reviews of diagnostic studies:didactic guidelines[J]. BMC Medical Research Methodology,2002, 2(1):667-676.
[8] 梁灼源 , 韦锋 , 欧阳楚君 , 等 . AnuA、抗 ds-DNA 抗体、抗 Sm 抗体和抗 rRNP 抗体对系统性红斑狼疮诊断及评价活动性的意义 [J]. 中国医学创新 , 2020,17(3): 155-158. LIANG Zhuoyuan,WEI Feng,OUYANG Chujun, etal. Significance of AnuA, anti ds-DNA, anti Sm andanti rRNP antibodies in the diagnosis and evaluationactivity of systemic lupus erythematosus [J]. MedicalInnovation of China, 2020, 17(3): 155-158.
[9] 张会芬 , 朱君娜 , 段素霞 . 抗 ds DNA 抗体、Anu A及抗 Sm 抗体检测在系统性红斑狼疮诊断中应用分析 [J]. 淮海医药 , 2019, 37(1): 11-13. ZHANG Huifen,ZHU Junna,DUAN Suxia. Applicationof joint detection of anti-dsDNA antibody, AnuAand anti-Sm antibody in diagnosis of systemic lupuserythemato-sus [J]. Journal of Huaihai Medicine,2019,37(1): 11-13.
[10] 冯明扬 . AnuA、抗 ds-DNA 抗体、抗 Sm 抗体联合检测诊断系统性红斑狼疮的价值 [J]. 牡丹江医学院学报 , 2019, 40(5): 61-62,79.FENG Mingyang.The value of combined detection ofAnuA, anti-DS-DNA antibody and anti-SM antibody indiagnosis of systemic lupus erythematosus[J].Journal ofMudanjiang Medical University,2019, 40(5): 61-62,79.
[11] 胡同平 , 张文兰 , 白力 , 等 . 2015 年某医院 402 例系统性红斑狼疮患者多种自身抗体检测结果分析 [J].中国药物与临床 , 2017, 17(2):157-159. HU Tongping,ZHANG Wenlan,BAI Li, et al. Analysisof autoantibodies in 402 patients with systemiclupus erythematosus hospitalized in 2015[J].ChineseRemedies & Clinics,2017, 17(2):157-159.
[12] 曹梦杰 . 抗核抗体谱 12 项检测在系统性红斑狼疮中的临床意义 [J]. 现代诊断与治疗 , 2017, 28(21):4025-4026. CAO Mengjie.The clinical significance of 12 detections by antinuclear antibody spectrum in systemiclupus erythematosus[J].Modern Diagnosis andTreatment,2017, 28(21) :4025-4026.
[13] 王永芹 , 王胜玉 , 张雪峰 . 抗核抗体谱检测对系统性红斑狼疮的诊断意义 [J]. 现代预防医学 , 2015.42(4):753-754,759. WANG Yongqin,WANG Shengyu,ZHANG Xuefeng.The diagnostic significance of antinuclear antibodyspectrum detection for systemic lupus erythematosus[J].Modern Preventive Medicine, 2015, 42(4):753-754,759.
[14] 黄银群 , 林秋强 , 陈绩才 , 等 . 抗 dsDNA 抗体、抗Sm 抗体、AnuA 和抗 rRNP 抗体联合检测对系统性红斑狼疮的诊断价值 [J]. 现代医院 , 2015. 15(6): 73-75. HUANG Yinqun,LIN Qiuqiang,CHEN Jicai,et al. Theclinical valuation in the diagnostic of systemic lupuserythemato-sus of combined detection of anti-dsDNAantibody, anti-Sm antibody, anti-nucleosome antibodyand anti-rrnp antibody [J]. Modern Hospital,2015,15(6):73-75.
[15] 张素华 , 薛小萍 . 抗核小体抗体对系统性红斑狼疮的临床诊断价值及意义 [J]. 国际检验医学杂志 ,2012, 33(23):2838-2839,2841. ZHANG Suhua,XUE Xiaoping. The diagnostic valueof anti-nucleosome antibodies in systemic lupuserythematosus [J]. International Journal of LaboratoryMedicine,2012, 33(23) :2838-2839,2841.
[16] 张辉 . 系统性红斑狼疮患者血清抗核小体抗体水平及其意义 [J]. 深圳中西医结合杂志 , 2010,20(1):25-28. ZHANG Hui. Research of anti-nucleosome antibodiesin systemic lupus erythematosus[J]. Shenzhen Journalof Integrated Traditional Chinese and WesternMedicine, 2010,20(1):25-28.
[17] 刘润荣 , 王晓东，路中 , 等 . 抗核小体抗体测定在系统性红斑狼疮诊断中的意义及价值 [J]. 潍坊医学院学报 , 2007, 29(2):117-119. LIU Runrong,WANG Xiaodong,LU Zhong, et al.The diagnosis significance of serum anti-nucleosomeantibodies and its value for lupus flare in systemiclupus erythematosus [J]. Acta Academiae MedicinaeWeifang,2007, 29(2):117-119.
[18] WANG Yanping ,LUO Peng, GUO Ting, et al.Studyon the correlation between anti-ribosomal P proteinantibody and systemic lupus erythematosus[J].Medicine, 2020，99(20)：e20192.
[19] 戚建锋 , 吴翡斐 , 施金俏 , 等 . 抗细胞膜 DNA 抗体在系统性红斑狼疮诊断中的应用价值 [J]. 浙江医学 ,2017, 39(21):1865-1867,1871. QI Jianfeng,WU Cuifei,SHI Jinqiao，et al. Diagnosticvalue of anti-cell membrane DNA antibodies forsystemic lupus erythematosus [J].Zhejiang Medical Journal,2017,39(21):1865-1867,1871.
[20] ALHARBI S, AHMAD Z, BOOKMAN A A, et al.Epidemiology and survival of systemic sclerosissystemic lupus erythematosus overlap syndrome[J]. TheJournal of Rheumatology, 2018. 45(10): 1406-1410.
[21] HEINLEN L D, MCCLAIN M T, MERRILL J,et al.Clinical criteria for systemic lupus erythematosus precede diagnosis, and associated autoantibodies are present before clinical symptoms[J].Arthritis Rheum,2007,56(7):2344-2351.
[22] MOHAN C, ADAMS S, STANIK V, et al. Nucleosome:a major immunogen for pathogenic autoantibody-inducing T cells of lupus[J]. The Journal of ExperimentalMedicine, 1993, 177(5):1367-1381.
[23] ?IVKOVI? V, STANKOVI? A, CVETKOVI? T，et al. Anti-dsDNA, Anti-Nucleosome and Anti-C1qantibodies as disease activity markers in patients withsystemic lupus erythematosus[J]. Srpski Arhiv zaCelokupno Lekarstvo, 2014, 142(7/8):431-436.
[24] NAVRATIL J S, AHEARN J M. Apoptosis, clearancemechanisms, and the development of systemic lupuserythematosus[J]. Current Rheumatology Reports,2001, 3(3):191-198.

备注/Memo

备注/Memo:
基金项目：国家自然科学面上基金（81972013）；安徽省转化医学研究院“A 类”科研项目（2017zhyx11）。
作者简介：刘欢欢（1997-），女，在读硕士，研究方向：肝癌、自身免疫性肝炎，E-mail：ay_hhliu@163.com。
通讯作者：陈礼文，男，副教授，副主任技师，研究生导师，E-mail：lw_ch@163.com。 潘发明，男，博士生导师，E-mail：famingpan@ahmu.edu.cn。
更新日期/Last Update: 1900-01-01