抗中性粒细胞胞浆抗体在肾炎综合征中的检测及其临床意义

Anti-neutrophil cytoplasmic antibodies and their target antigens in patients with nephritic syndrome

目的 探讨检测抗中性粒细胞胞浆抗体 (ANCA)及其靶抗原在肾炎综合征中的临床意义。方法 应用间接免疫荧光 (IIF)法检测 10 0例肾炎综合征患者血清抗中性粒细胞胞浆抗体 ,对其阳性的 2 9例用酶联免疫吸附试验 (ELISA )检测靶抗原髓过氧化物酶 (MPO)和蛋白酶 3(PR3 )。结果 IIF检测肾炎综合征ANCA阳性率为 2 9% ,其中胞浆型 10 %、核周型 19%。急进型肾炎、狼疮性肾炎、紫癜性肾炎阳性率分别为 5 6%、2 0 %和 15 %。ELISA急进性肾炎和紫癜性肾炎大多数识别靶抗原MPO ,狼疮性肾炎ANCA不识别MPO或PR3。结论 ANCA在急进性肾炎和狼疮性肾炎中阳性率较高 。

Objective To investigate the clinical significance of anti neutrophil cytoplasmic antibodies(ANCA) and their target antigens in nephritis syndrome.Methods 100 serum samples were collected and indirect immunofluorescence(IIF)was used to detect ANCA ,ELISA was used detect the profeinase 3(PR3) and myeloperoxidase(MPO)in 29 ANCA positive samples.Results 29% sera showed ANCA positive by IIF method,10% were cytoplasmic ANCA(c ANCA),19% were peripheral nuclear ANCA(p ANCA)The positive rate of rapidly progressive glomerulonephritis,lupus nephritis and anaphylactic purpura nephritis were 56%,20% and 15%.Respectively, ELISA testing showed that most of ANCAs in rapidly progressive glomerulonephritis and anaphylactic purpura nephritis recognized MPO, lupus nephritis didn't.Conclusions It showed the high positive rate of ANCA in rapidly progressive glomerulonephritis and lupus nephritis and showed the important diagnostic significance. might be correlated with lupus activities.