摘要
回顾本实验室开展的免疫印迹法(LIA)检测抗核抗体(ANA)谱(14项)与间接免疫荧光法(IIF)检测抗核抗体的结果,比较分析两种方法的相关性和差异性,探讨这两种方法在临床检测自身抗体中的价值。方法:752例标本分别采用免疫印迹法作为确认试验检测抗核抗体谱和间接免疫荧光法作为筛查试验检测抗核抗体,将检测结果进行比对分析。结果:752例患者中,两种方法的阳性率分别为27.26%(IIF)和27.66%(LIA),IIF和LIA两种方法间的检测结果无显著性差异,统计学上一致性一般(P=0.875,kappa=0.463);无论何种方法检测,女性患者较男性的ANA阳性率明显增高,统计学差异显著(P=0.000)。IIF对ANA谱14项特异性抗体的检出率不同:抗M2抗体、抗SS-B抗体、抗核糖体P蛋白抗体、抗核小体抗体和抗着丝点抗体的检出率较高(>80%);抗dsDNA抗体、抗PCNA抗体、抗Sm抗体、抗SS-A抗体、抗U1-RNP抗体和抗组蛋白抗体的检出率一般(50%～80%);对特异性自身抗体抗Jo-1抗体、抗PM-Scl抗体和抗Scl-70抗体阳性患者的检出率较低(<50%)。IIF阳性患者的LIA结果分析:LIA阳性患者的IIF阳性稀释倍数以高低度的(≥1∶1 000)为主,占64.3%,而LIA阴性患者的IIF阳性稀释倍数低滴度(1∶100)所占百分比最高(50.5%)。IIF法敏感性较高,LIA法特异性较高,临床上对于抗核抗体的检测可先采用IIF筛查,再进行LIA确认;对临床有AID症状的患者而IIF阴性者,可采用ELISA法或LIA法等方法检测其特异性抗体;而对于IIF高滴度而LIA阴性、尤其临床症状不明显的患者,建议临床上要给予高度重视并定期随访。
Retrospective analysis on the results of antinuclear antibody test, to investigate the correlation between indirect immunofluorescence assay for screening ANA and line immunoassay for specific ANA, 752 specimens were tested by IIF-ANA and LIA-ANAs. Among 752 cases, the positive rate of the two methods were 27.26% （IIF） and 27.66%（LIA）, and two methods showed no statistically difference （P=0. 875, kappa=0. 463）. ANA-positive rate of men and women showed significant difference （15.5 % vs. 32.71%, P= 0. 000）. The detection rate of IIF for specific autoantibodies such as anti-Jo-1, anti- PM-Scl and anti-Scl-70 is low. IIF＋/LIA＋ patients had high-titer≥ 1 ： 1000, accounting for 64.3%, while IIF＋/LIA- patients had low-titer 1 ： 100, accounting for 50.5 %. IIF can be used for screening the antinuclear antibodies, then LIA for confirmation. For those IIF＋/LIA- patients： if they have obvious clinical symptoms of AID but IIF test is negative, LIA test should be performed for confirmation; for those IIF＋/LIA- patients with high titer, especially in those patients with subclinical symptoms, clinical attention should be given, and regular follow-up is recommended.
出处
《现代免疫学》
CAS
CSCD
北大核心
2012年第2期159-163,共5页
Current Immunology
关键词
抗体
抗核
荧光抗体技术
间接
自身免疫疾病
antinuclear, antibodies
indirect, immunofluorescence
autoimmune disease
