抗中性粒细胞胞质抗体和抗酿酒酵母抗体表达在炎症性肠病诊断中的意义

The role of expression of perinuclear anti-neutrophil cytoplasmic antibody and anti-Saccharomyces cerevisiae antibody in the diagnosis of inflammatory bowel diseases

目的回顾性分析血清核周型抗中性粒细胞胞质抗体(pANCA)和抗酿酒酵母抗体(ASCA)的表达在炎症性肠病(IBD)诊断中的意义。方法间接免疫荧光生物薄片(IIFT)法检测97例IBD患者血清pANCA、ASCA表达,其中86例溃疡性结直肠炎(UC)列入UC组,11例克罗恩病(CD)列入CD组,另设36例结肠镜检查正常者为对照组。结果pANCA在UC、CD和对照组的阳性率分别为27.9%、0%和0%,UC组显著高于其他两组(P<0.01);ASCA在CD、UC和对照组的阳性率分别为36.4%、4.7%和0%,CD组显著高于其他两组(P<0.01)。86例UC患者中,重度UC 23例(26.7%),其中pANCA+6例(26.1%),ASCA+2例(8.7%),pANCA+/ASCA+1例(4.4%);轻、中度UC 63例(73.3%),其中pANCA+18例(28.6%)。重度与轻、中度UC患者pAN-CA表达情况无显著差异(P>0.05)。11例CD患者中,重度CD 4例(36.4%),其中ASCA+3例(75.0%);轻、中度CD 7例(63.6%),其中ASCA+1例(14.3%)。重度CD患者ASCA阳性率明显高于轻、中度CD患者(P<0.05)。结论ASCA、pANCA两种血清标志物对诊断UC和CD具有一定临床参考价值。

Objective To analyze the diagnostic significance of the expression of perinuclear anti-neutrophil cytoplasmic antibody （pANCA） and anti-Saccharomyces ceredsiae antibody （ASCA） in the patients with inflammatory bowel disease （IBD）. Methods Serum sanaples were collected from 97 patients with IBD, including 86 patients with ulcerative colitis （UC） and 11 with Crohnls disease （CD）. Another group of 36 persons in whom colonoscopic examination was negative served as control. Determinations of ASCA and pANCA were performed using indirect immunofluorescence test （IIFT）. Results The positive rate of pANCA in group UC, CD and control was 27. 9%, 0% and 0%, respectively. Obviously, the rate in group UC was higher than that in the other two groups （P〈0. 01）. The posifive rate of ASCA in group CD, UC and control was 36. 4%, 4. 7% and 0%, respectively. The rate in group CD was significantly higher than that in the other two groups （P〈0. 01）. Among 23 severe UC patients out of 86 UC patients （26. 7%）, 6 were found pANCA positive （26.1%）, 2 were ASCA positive （8.7%） and 1 was pANCA＋/ASCA＋ （4.3%）. Among 63 moderate UC cases out of 86 IX; patients （73. 3%）, 18 were pANCA＋ （28.6%）. No significant difference was found in the positive ratio of pANCA between severe and moderate UC eases （P〉0. 05）. Four of 11 CD patients （36. 4%） were severe eases, among them 3 showed ASCA ; 7 were moderate cases （63. 6%）, and among them I ease showed ASCAP. The positive ratio of ASCA was significantly different between severe and moderate CD cases （P〈0. 05）. Detection of expression of pANCA and ASCA contributes to a valuable diagnostic tool in the diagnosis of UC and CD.