摘要
目的:进一步阐明不同抗原抗中性粒细胞胞浆抗体(ANCA)在微型多动脉炎(MPA)诊断中的意义。方法:首次在国内对39例MPA患者进行了间接免疫荧光(IIF)┐ANCA,髓过氧化物酶(MPO)┐ANCA,细菌渗透增强蛋白(BPI)┐ANCA和蛋白酶3(PR3)┐ANCA检测,并结合临床和病理特点进行了分析。结果:39例中ANCA阳性者25例(64.10%),其中IIF┐ANCA阳性率为17.95%,MPO┐ANCA为38.46%,BPI┐ANCA为20.51%,PR3┐ANCA为7.69%,各种ANCA试验可单独阳性,也可合并存在,以MPO┐ANCA的合并存在率最高。结论:ANCA在MPA诊断中具有肯定意义,不仅是MPA诊断的一个血清学标志,而且是疾病活动和进展的标志之一。从临床实际出发同时检测MPO┐ANCA、BPI┐ANCA。
BACKGROUND Anti neutrophil cytoplasmic antibodies(ANCAs) have been linked with systemic vasculitides and various kind of connective tissue diseases, but the significance of different ANCAs has not yet been extensively studied in microscopic polyangiitis(MPA). To elucidate the significance of antibodies to different neutrophil cytoplasm antigens in the diagnosis of MPA,a retrospective analysis was made in 39 patients with MPA in the present study. METHODS 〖WTBZ]IIF ANCA was detected by indirect immunoflurence assay, MPO ANCA (anti myeloperoxidase), BPI ANCA (anti bactericidal/permeability increasing protein) and PR3 ANCA(anti proteinase 3) were measured by ELISA. Clinical and renal pathological data were analyzed with regard to the different patterns of these autoantibodies. RESULTS 〖WTBZ] Patients positive for any one of the ANCAs accounted for 64.10% in this group of MPA patients. The percentages of patients with positive IIF ANCA,MPO ANCA,BPI ANCA and PR3 ANCA were 17.95%,38.46%, 20.51% and 7.69% respectively. The most frequent ANCAs in patients with MPA was MPO ANCA. No patient was found positive for very of the four ANCAs. The percentages of patients positive for three ANCAs, two ANCAs and one ANCA were 2.56%, 15.38%, 46.15% respectively. Rapidly progressive glomerulonephritis syndrome and arthropathy were more frequent in ANCA positive patients, as compared with ANCA negative patients ( P <0.05, P <0.01). No significant difference was found in the clinical and renal pathological manifestations among patients with different patterns of ANCAs, although different patterns of ANCAs were related to different clinical and histopathology features. CONCLUSION 〖WTBZ] ANCAs are not only diagnostic parameters for MPA, but also a marker of disease activity. MPO ANCA,BPI ANCA and IIF ANCA should be detected simultaneously for the diagnosis of MPA
出处
《肾脏病与透析肾移植杂志》
CAS
CSCD
1996年第5期1-6,共6页
Chinese Journal of Nephrology,Dialysis & Transplantation
关键词
动脉炎
中性粒细胞胞浆
抗体
微型多动脉炎
anti neutrophil cytoplasmic antibodies microscopic polyangiitis diagnosis