摘要
目的探讨抗核抗体(ANA)、抗核抗体谱(ANAs)及其联合检测对自身免疫性疾病(AID)的诊断价值。方法笔者所在医院1095例疑似AID患者作为研究对象,采集其血清标本,以间接免疫荧光法(IIF)检测其ANA,以免疫印迹法(IBT)检测其ANAs,并对结果进行统计学分析,评估ANA、ANAs及其联合检测对AID的诊断价值。结果 1095例受检者血清标本中,ANA检测阳性率为46.67%(511/1095),ANAs检测阳性率为44.75%(490/1095),两者符合率为75.80%,一致性为κ=0.511(P<0.05)。ANA阳性标本荧光核型以核颗粒型、核均质型、混合型为主,ANA(+)/ANAs(+)标本荧光核型中,着丝点型、核颗粒型、混合型阳性率较高。不同荧光滴度ANA阳性率、ANAs阳性率均存在差异,随着荧光滴度的增高,ANA阳性降低(P<0.05),ANAs阳性率升高(P<0.05)。ANAs阳性标本特异性抗体类型以Ro-52、SS-A和nRNP/Sm为主,ANAs(+)/ANA(+)标本中Ro-52、SS-A和nRNP/Sm阳性比例较高,ANAs(+)/ANA(-)标本中,Scl-70、PM-Scl、PCNA阳性比例较高。ANA+ANAs检出率显著高于ANA、ANAs检出率(P均<0.05)。结论 ANA、ANAs检测均对AID具有一定诊断价值,联合检测可提高AID检出率,降低漏检率。
Objective To investigate the diagnostic value of antinuclear antibody (ANA),antinuclear antibodies (ANAs) and combined detection of both for autoimmune diseases(AID). Methods A total of 1,095 patients with suspected AID in author's hospital were enrolled in this study,and their serum samples were collected. ANA was detected by indirect immunofluorescence(IIF),and ANAs were detected by immunoblotting (IBT). Statistical analysis was performed on the results to evaluate the diagnostic value of ANA,ANAs and combined detection of both for AID. Results Among the serum samples of 1,095 subjects,the positivity rates of ANA and ANAs were 46.67%(511/1095) and 44.75%(490/1095),respectively. The coincidence rate of the two methods was 75.80%(κ=0.511,P<0.05). The main fluorescent karyotypes of ANA-positive specimens included nuclear particle type,nuclear homogenization type and mixed type. Among the fluorescent karyotypes of ANA(+)/ANAs(+) specimens,the positivity rate of centromere type,nuclear particle type and mixed type was higher. There were differences in positivity rate of ANA and ANAs between different fluorescence titers. With the increase of fluorescence titer,the positivity rate of ANA decreased(P<0.05),while the positivity rate of ANAs increased(P<0.05). The specific antibody types of ANAs positive specimens were mainly on Ro-52,SS-A and nRNP/Sm. The proportions of positive Ro-52,SS-A and nRNP/Sm in ANAs(+)/ANA(+) specimens were higher. Among the ANAs(+)/ANA(-) specimens,the proportion of positive Scl-70,PM-Scl,and PCNA was higher. The detection rate of ANA combined with ANAs was significantly higher than that of alone ANA or ANAs(all,P<0.05). Conclusion Both ANA and ANAs are of certain clinical value for the diagnosis of AID,but the combined detection of both can uplift the detection rate of AID and reduce the rate of missed detection.
作者
郭佳佳
蒋晓钦
李琰
慕珂珂
董炎红
GUO Jia-jia;JIANG Xiao-qin;LI Yan(Dept. of Medical Laboratory,No. 988 Hospital of PLA,Zhengzhou,Henan 450007,China)
出处
《实用医药杂志》
2019年第5期402-405,共4页
Practical Journal of Medicine & Pharmacy
关键词
抗核抗体
抗核抗体谱
间接免疫荧光法
免疫印迹法
自身免疫性疾病
Antinuclear antibody
Antinuclear antibodies
Indirect immunofluorescence
Immunoblotting
Autoimmune disease
