中文摘要：

目的检测SLE患者血清中抗染色质抗体（anti—chromatinantibody，AchA）水平，评价其在SLE诊断和病情发展中的意义。方法选取SLE患者154例，疾病对照组155例（类风湿关节炎46例，干燥综合征49例，骨关节炎10例，系统性硬化症20例，肾病综合征30例），健康人对照107名。用ELISA检测AchA水平，并探讨其与SLE患者发病年龄、病程、疾病活动指数（SLEDAI）评分、其他自身抗体、补体、免疫球蛋白（IgG）、ESR、24h尿蛋白、肾功能指标等的关系。结果SLE患者血清中AchA的阳性率为63．6％（98／154），明显高于疾病对照组5．8％（9／155）及健康人对照组0％（P均〈0．01）。AchA诊断SLE的特异性为96．6％，敏感性为63．6％，阳性预测值和阴性预测值分别为91．6％和81．9％。SLE患者血清中AchA水平明显高于疾病对照组和健康人对照组（P均〈0．0001）。与AchA阴性SLE患者比较，AchA阳性SLE患者SLEDAI评分、24h尿蛋白水平、ESR升高，C3、C4、WBC降低，抗核小体抗体（AnuA）、抗dsDNA抗体、抗核糖体P蛋白抗体水平升高（P均〈0．05）。相关性分析显示，AchA水平与ESR（r=0．218，P=0．01）、C3（r=0．451，P〈0．0001）、Alb（r=0．295，P〈0．0001）、AnuA（r=0．349，P〈0．0001）、抗dsDNA抗体（r=0．311，P〈0．0001）、24h尿蛋白（r=0．243，P=0．003）、SLEDAI评分（r=0．202，P=0．015）均具有相关性。结论AchA对SLE的诊断具有较高的敏感性和特异性，并且与疾病活动及病情严重程度相关，与狼疮肾损害强相关，提示其在狼疮肾发病及病理过程中的重要作用。

英文摘要：

Objective To detect anti-chromatin antibody （AchA） in serum of patients with systemic lupus erythematosus （SLE）, and evaluate its diagnosis value and clinical significance during the development of the disease. Methods Serum samples were obtained from 154 patients with SLE, 155 non-SLE autoimmune disease controls, including 46 rheumatoid arthritis, 49 Sjtgren＇s syndrome, 10 osteoarthritis, 20 systemic sclerosis, 30 nephrotic syndrome, and 107 healthy individuals. The anti-chromatin antibody was examined by enzyme-linked immunosorbent assay （ELISA）. The associations between the antibody and age of SLE onset in patients, duration, disease activity index （SLEDAI） score, other autoantibodies, complement, immunoglobulin G （IgG）, erythrocyte sedimentation rate （ESR）, 24 hour urine protein, renal function were explored. Results The anti-ehromatin antibody was present in 63.6% （98/154） of SLE patients and the positive rates were significantly higher than those in other autoimmune diseases （5.8%） and healthy control （0） （ P 〈 0.01 ）. The specificity and sensitivity of anti-chromatin antibody were 96.6% and 63.6% respectively. The positive predic- tive value and negative predictive value were 91.6% and 81.9% respectively. The level of anti-chromatin antibody in SLE patients were significantly higher than those in other groups （P 〈 0. 0001 ）. The SLEDAI score, 24 hours urine protein, ESR, incidence of an- ti-dsDNA, anti-nucleosome antibodies and anti-ribosomal P protein antibody in anti-chromatin antibody positive group were much higher than those in anti-chromatin antibody negative group, and C3, CA and WBC were significantly reduced（ P 〈 0.05 ）. Correlation analy- sis showed that anti-chromatin antibody was correlated with ESR （ r = 0. 218, P = 0.01 ） , complement 3 （ r = 0. 451, P 〈 0. 0001 ）, Albumin （ r = 0. 295, P 〈 0. 000 1 ）, anti-nucleosome antibodies （ r = 0. 349, P 〈 0. 000 1 ） , anti-dsDNA antibodies （ r = 0.311, P 〈 0.000 1）, 24