抗桥粒芯蛋白1、3抗体及大疱性类天疱疮180、230抗体联合检测诊断大疱性皮肤病的应用价值

Application value of anti⁃desmoglein 1 and 3 antibodies and bullous pemphigoid 180 and 230 antibodies in the diagnosis of bullous dermatosis

目的 探讨抗桥粒芯蛋白1、3(Dsg1、3)抗体及大疱性类天疱疮180、230(BP180、230)抗体联合检测在大疱性皮肤病临床诊断中的应用价值。方法 自2020年3月至2023年1月,纳入郑州大学第一附属医院收治的经组织病理结果、直接免疫荧光检测确诊的大疱性皮肤病患者88例为观察组,选取本院同期健康体检者76名为对照组。分析两组Dsg1、Dsg3、BP180、BP230抗体的阳性检出情况;分析观察组血清Dsg1、Dsg3、BP180、BP230抗体标本诊断类型占比及观察组不同年龄组大疱性皮肤病疾病类型阳性率占比;绘制ROC曲线分析Dsg1、Dsg3、BP180、BP230抗体单一及联合检测对大疱性皮肤病的诊断价值。结果 两组血清Dsg1、Dsg3、BP180、BP230抗体阳性率比较差异具有统计学意义(P<0.05)。据Dsg1、Dsg3、BP180、BP230抗体检测结果,诊断类型:BP、PV、PF、PF+BP、PV+BP阳性率分别为32.95%、20.45%、11.36%、7.95%、3.41%。其中BP阳性率占比最高,PV+BP阳性率占比最低,两者比较差异具有统计学意义(P<0.05)。>60岁组BP阳性率高于≤60岁组,PV及PF阳性率低于≤60岁组,差异有统计学意义(P<0.05)。Dsg1、Dsg3、BP180、BP230抗体联合检测对大疱性皮肤病灵敏度、特异度分别为91.02%、88.66%,AUC(95%CI)为0.821(0.745~0.911),均高于上述抗体单一检测(P<0.05)。结论 Dsg1、Dsg3、BP180、BP230抗体在大疱性皮肤病诊断中具有重要参考价值,且联合检测可提高诊断的准确性;大疱性皮肤病患者年龄和抗体类型之间也存在一定的关联,联合检测Dsg1、Dsg3、BP180、BP230抗体有助于大疱性皮肤病进行更精细的诊断和治疗。

Objective To explore the application value in the clinical diagnosis of bullous derma-tosis by detecting antibodies against desmoglein 1,3(DSG 1,3)and bullous pemphigoid 180,230(BP 180,230).Methods This study was a retrospective,double-blind trial conducted from March 2020 to January 2023.The study included 88 patients with Bullous pemphigoid diagnosed based on histopathological results and direct immunofluorescence detection at our hospital as the observation group.Additionally,76 patients who un-derwent physical examinations at our hospital during the same period were selected as the control group.The study aims to analyze the positive detection of Dsg1,Dsg3,BP180,and BP230 antibodies in the serum of all study subjects.It also aimed to determine the percentage of diagnostic types of serum Dsg1,Dsg3,BP180,and BP230 antibody specimens in the observation group,as well as the percentage of positive rates of Bullous pemphigoid disease types in different age groups within the observation group.Furthermore,the study aimed to draw the ROC curves to analyze the diagnostic value of single and combined testing of Dsg1,Dsg3,BP180,and BP230 antibodies for Bullous pemphigoid.Results The difference in the positive rates of serum Dsg1,Dsg3,BP180 and BP230 antibodies between the two groups was statistically significant(P<0.05).Ac-cording to the results of the Dsg1,Dsg3,BP180 and BP230 antibody tests,the positive rates of diagnostic types for BP,PV,PF,PF+BP and PV+BP were 32.95%,20.45%,11.36%,7.95%and 3.41%,respective-ly.The percentage of BP positivity was the highest,while the percentage of PV+BP positivity was the lowest,and the difference between them was statistically significant(P<0.05).The rate of BP positivity was higher in the>60-year-old group than in the≤60-year-old group,and the rate of PV and PF positivity was lower than in the≤60-year-old group(P<0.05).The sensitivity and specificity of the combined detection of antibodies against Dsg1,Dsg3,BP180 and BP230 were 91.02%and 88.66%respectively,and the AUC(95%CI)was 0.821(0.745~0.911),which was higher than the single detection of the above antibodies(P<0.05).Conclusion Dsg1,Dsg3,BP180,and BP230 antibodies have significant reference value in the diagnosis of Bullous pemphi-goid.The combination of these tests can improve diagnostic accuracy.There is also a correlation between the age of patients with Bullous pemphigoid and the type of antibody.Combined detection of Dsg1,Dsg3,BP180,and BP230 antibodies is helpful for a more precise diagnosis and treatment of Bullous skin diseases.