目的 分析抗双链DNA抗体（anti-double-stranded DNA antibodies，Anti-dsDNA）定量、抗核抗体（antinuclear antibody，ANA）及抗中性粒细胞胞浆抗体（anti-neutrophil cytopasmic antibodies，ANCA）联合检测在系统性红斑狼疮（systemic lupus erythematosus，SLE）诊断及病情评估中的应用价值。 方法 选取2024年5—12月安徽医科大学第一附属医院风湿免疫科收治的154例SLE患者（SLE组，其中活动期115例，非活动期39例）及同期100例非SLE患者（非SLE组）、50例健康志愿者（对照组），比较其临床资料及Anti-dsDNA、ANA、ANCA检测结果，分析活动期SLE患者Anti-dsDNA、ANA、ANCA阳性与肾损害、SLE疾病活动指数（SLEDAI）评分的相关性，二元logistic回归分析SLE患者活动期的危险因素，绘制受试者工作特征曲线（ROC）分析Anti-dsDNA、ANA及ANCA对SLE患者活动期的评估价值。 结果 SLE组Anti-dsDNA、ANA、ANCA阳性率分别为55.84%（86/154）、100%（154/154）、22.08%（34/154），在ANA阳性者中，SLE荧光核型主要有均质型42.85%（66/154）、核颗粒型23.38%（36/154）及其相关混合型29.22%（45/154）；SLE组Anti-dsDNA、ANCA阳性率高于非SLE组（P < 0.05）；SLE活动期患者肾损害发生率、SLEDAI评分、IgA、IgM、IgG及Anti-dsDNA、ANCA阳性率高于非活动期患者，活动期患者血清补体C3、C4水平低于非活动期患者（P < 0.05）；活动期SLE患者Anti-dsDNA、ANA、ANCA阳性率与肾损害、SLEDAI评分呈正相关（P < 0.05）；SLEDAI评分、Anti-dsDNA、ANCA阳性均是SLE活动期的独立危险因素（P < 0.05）；SLEDAI评分、Anti-dsDNA、ANCA阳性联合预测SLE活动期的曲线下面积为0.819（95%CI：0.738 ~ 0.900），高于各指标单独预测结果（Z = 2.291、2.638、4.848，P < 0.05）。 结论 Anti-dsDNA、ANA、ANCA在SLE患者中有较高检测意义，其中Anti-dsDNA、ANCA与患者疾病活动度、肾损害有关，对其进行检测可较好评估病情。

Objective To analyze the significance of the combined detection of anti-double-stranded DNA （anti-dsDNA） antibody quantification， antinuclear antibody （ANA）， and anti-neutrophil cytoplasmic antibody （ANCA） in the diagnosis and assessment of the severity of systemic lupus erythematosus （SLE）. Methods A total of 154 SLE patients （SLE group， comprising 115 active cases and 39 inactive cases） who were admitted to the Department of Rheumatology and Immunology， the First Affiliated Hospital of Anhui Medical University between May and December 2024， 100 non-SLE patients （non-SLE group）， and 50 healthy volunteers （control group） were simultaneously enrolled in this study. Clinical data as well as the test results of anti-dsDNA， ANA， and ANCA were compared across the groups. The correlation between the positivity of anti-dsDNA， ANA， and ANCA and renal damage， along with the SLE disease activity index （SLEDAI） score in active SLE patients， was analyzed. Binary logistic regression was employed to identify the risk factors for active SLE， and receiver operating characteristic （ROC） curves were plotted to assess the value of anti-dsDNA， ANA， and ANCA in evaluating active SLE. Results The positive rates of anti-dsDNA， ANA， and ANCA in the SLE group were 55.84% （86 out of 154）， 100% （154 out of 154）， and 22.08% （34 out of 154）， respectively. Among the individuals testing positive for ANA， the predominant fluorescent patterns in SLE cases were the homogeneous pattern （42.85%， 66 out of 154）， the nuclear granular pattern （23.38%， 36 out of 154）， and the related mixed pattern （29.22%， 45 out of 154）. The positive rates of anti-dsDNA and ANCA in the SLE group were significantly higher than those in the non-SLE group （P < 0.05）. The incidence of renal damage， SLEDAI scores， IgA， IgM， and IgG levels， as well as the positive rates of anti-dsDNA and ANCA， were notably higher in patients with active SLE compared to those with inactive SLE， whereas the serum complement C3 and C4 levels were lower in active patients （P < 0.05）. In patients with active SLE， the positive rates of anti-dsDNA， ANA， and ANCA were positively and significantly correlated with renal damage and SLEDAI score （P < 0.05）. SLEDAI score， anti-dsDNA positivity， and ANCA positivity were identified as independent risk factors for active SLE （P < 0.05）. The area under the curve （AUC） of the combination of SLEDAI score， anti-dsDNA， and ANCA for predicting active SLE was 0.819 （95%CI： 0.738 ~ 0.900）， which was significantly greater than that of each indicator alone （Z = 2.291， 2.638， 4.848， P < 0.05）. Conclusion Anti-dsDNA， ANA， and ANCA are highly valuable for detection in patients with SLE. Specifically， anti-dsDNA and ANCA are closely associated with disease activity and renal damage. Conducting tests on these markers can effectively assist in the evaluation of the patients'condition.