Hela抗原和Ehrlich抗原检测抗RA33、RA36抗体的比较研究

A comparison in the detection of anti-RA33/36 antibody with Hela antigen and Ehrlich antigen

目的探讨Ehrlich抗原能否取代Hela抗原检测抗RA33、36抗体,为临床提供简便、可靠的检测手段。方法分别以Hela细胞核提取物和Ehrlich腹水瘤细胞核提取物为抗原,用免疫印迹法,对281例类风湿关节炎(RA)、89例其他风湿病以及50名正常人血清进行检测。结果两种抗原均可以检出抗 RA33、抗RA36抗体,但检测结果一致率只有65．5％。抗A33和抗RA36抗体不仅见于RA,也见于系统性红斑狼疮等其他风湿病。281例RA中,Hela抗原和Ehrlich抗原检测结果对RA诊断的敏感性和特异性分别为34．8％和83．5％对44．1％和71．9％。两者联合,敏感性达52．3％,特异性70．5％。两种抗原检测的阳性结果一致者,其病情活动性和预后不良的指标多数高于结果均阴性者。结论抗RA33抗体和抗RA36抗体都不是RA的标志性抗体。Hela抗原和Ehrlich抗原不能互相代替。同时使用两种抗原进行抗RA33/36抗体的检测能提高对RA诊断的敏感性,并有助于RA病情活动性的判断和预后估计。

Objective To determine whether Hela antigen could be replaced by Ehrlich antigen in detecting anti-RA33/36 antibody, thus to present a simple and reliable method for detecting anti-RA33/36 antibody in rheumatoid arthritis（RA）. Methods Anti-RA33/36 antibody was detected by using western blotting with Hela antigen and Ehrlich antigen respectively in 281 patients with RA,89 with miscellaneous rheumatic diseases and 50 healthy.individuals. Results Anti-RA33 antibody and anti-RA36 antibody of identical result was only 65.5 %. Anti RA33 antibody and anti RA36 antibody existed not only in RA patients, but also in systemic lupus erythematosus, mixed connective tissue disease,and some other rheumatic diseases. Among 281 cases of RA patients the diagnostic sensitivity and specificity for RA were 34.8 % and 92.1 96 by Hela antigen,44.1% and 88.5 % by Ehrlich antigen, and 52.3 % and 70.5 % by combine both antigens. In ease a testing result was identically positive by both of the two antigens,the disease were more severe than those of negative cases. Conclusions Both anti RA33 and anti RA36 antibody are not marker antibody for RA. Hela antigen and Ehrlich antigen eann＇ t be replaced each other. Detecting anti RA33 and anti RA36 antibody with both of Hela antigen and Ehrlich antigen is helpful to increase the sensitivity for the diagnosis of RA,and the assessment of the disease activity and severity of RA.