摘要
目的比较酶联免疫吸附实验(ELISA)、免疫双扩散(ID)和免疫印迹(IB)3种方法检测抗-SSA/Ro 抗体,评价3种方法的符合度,同时提高 IB 检测相对分子质量52000条带的认识。方法采用 ELISA 法、IB 法及 ID 法检测以下3组对象的抗-SSA/Ro 抗体水平:正常献血员血清122份;实验室常规检测血清7736份;诊断明确结缔组织病血清166份。结果(1)正常献血员122份血清 ELISA、ID 和 IB 检测抗-SSA/Ro 抗体全部阴性;(2)实验室常规检测的7736份血清,IB 检测相对分子质量52000阳性1085例,其中抗核抗体和其他抗-ENA 抗体均阴性的有92份,该组病人经过 ID 和ELISA 两种方法检测全部阴性;(3)结缔组织病组166例,ELISA、ID 和 IB 检测抗-SSA/Ro 抗体的阳性率分别是76.5%(127/166),65.1%(108/166),49.4%(82/166);(4)结缔组织病166份血清中,ELISA 和 ID 两种方法检测的符合率88.6%(147/166),两种方法的比较,X^2=17.1,P<0.001;ID 和IB 两种方法检测的符合率为75.9%(126/166),两种方法的比较,X^2=15.6,P<0.001;(5)ELISA 和ID 进行 Spearman 等级相关分析,相关系数为0.828,P<0.001。结论(1)ELISA 和 ID 特异性优于IB。(2)IB 特异性较差,但如果同时 ANA 和或抗-ENA 其他条带阳性,特异性会显著提高。(3)ELISA敏感性优于 ID,ID 敏感性优于 IB。(4)ELISA 和 ID 结果在数值上存在显著的正相关关系。
Objectives To compare the specificity and sensitivity of ELISA, double immunodiffusion （ ID）, and immunoblotting （IB） in detection of anti-SSA/Ro antibodies in the sera of patients with connective tissue disease （CTD）. Methods ELISA, double ID, and IB were used to detect the serum levels of anti-SSA/Ro antibodies in 7736 patients undergoing screening of CTD, 122 healthy blood donors, and 166 CTD patients positive in antinuclear antibody （ANA） and/or anti-extractable nuclear antigen （ENA）. Results （ 1 ） The sera of the 122 healthy blood donors were all negative in anti-SSA/Ro antibodies by these three methods. （2） 1085 of the 7736 sera undergoing screening of CTD were positive in the anti-SSA/R0 antibody of the relative molecular quantity of 52 000. Ninety-two of the 1085 patient, ANA and/or anti-ENA negative, were all confirmed by ELISA and ID to be negative in anti-SSA/R0 antibodies. And 993 of these 1085 patients were positive in ANA and/or anti-ENA antibody, 917 of which were shown to be anti-SSA/R0 antibodies positive by ELISA （92.3%, 917/993）, and 860 of which were shown to be anti-SSA/R0 antibodies positive by ID （86. 6%, 860/993） . （3） The prevalence rates of anti-SSA/Ro antibodies in the 166 CTD patients detected by ELISA, ID, and IB respectively were 76. 5% （ 127/166）, 65. 1% （ 108/166）, and 49. 4% （82/166） respectively. （4） 127 of the 166 sera of the CTD group were anti-SSA/Ro antibody positive By ELISA, and 108 of the 166 sera were anti-SSA/R0 antibody positive by ID, with a coincidence rate of ELISA and ID of 88.6% （ 147/166）, and there was a significant difference in positive rate of anti-SSA/Ro antibody between these two methods （ P 〈 0. 001 ）. 81 of the 166 CTD sera were anti-SSA/Ro antibody positive with a positive rate of 63. 8%. The coincidence rate of ID and IB was 75.9% （126/166） and there was a significant difference in positive rate of anti-SSA/Ro antibody between ID and IB methods too （P〈0. 001 ）. （5） Spearman＇s rank correlation study showed that the correlation coefficient between ELISA and ID was 0. 828 （ P 〈 0. 001 ）. Conclusions （ 1 ） ELISA and ID are more specific than IB in detection of anti-SSA/Ro antibody. （2） The specificity of IB was lower, however, when ANA and/or other anti-ENA are positive, its specificity would be improved markedly. （3） ELISA is more sensitive than ID, and ID is more sensitive than IB in detection of anti-SSA/Ro antibody. （4） There is a significant positive correlation between ELISA and ID quantitatively.
出处
《中华医学杂志》
CAS
CSCD
北大核心
2006年第35期2455-2457,共3页
National Medical Journal of China
