RF，抗RA33抗体，CRP，ANA与ENA联合检测在间质性肺炎及相关疾病中的临床研究

Clinical Research of RF,Anti-RA33 Antibody,CRP,ANA with ENA Combined Detection of Auto Antibodies in Diagnosis and Treatment of Interstitial Pneumonia and Correlate Disease

目的了解引起间质性肺炎的发病情况及相关因素，探讨血清RF，抗RA33抗体，CRP，ANA及ENA联合检测在间质性肺炎及相关疾病诊断、治疗及预后中的作用。方法采用ELISA法对32例间质性肺炎患者，37例类风湿性关节炎患者，30例普通肺炎患者和30例健康对照者进行抗RA33抗体的检测，间接免疫荧光法检测ANA，免疫印迹法检测ENA，免疫比浊法进行类风湿因子（RF）及CRP的检测。结果闷质性肺炎组患者RF水平与类风湿性关节炎组比较，差异非常显著（P〈0．01）；间质性肺炎组患者CRP水平与健康对照组比较，差异非常显著（P〈0．01）；间质性肺炎组患者抗RA33抗体水平与健康对照组比较，差异显著（P〈0．05）。各疾病组间抗RA33抗体水平比较，差异无统计学显著性意义（P〉0．05）；RF，抗RA33抗体，CRP及ANA诊断间质性肺炎灵敏度分别为：34．38％，25．00％，56．25％，78．13％；诊断普通肺炎灵敏度分别为：10．00％，6．67％，80．00％，16．67％；诊断类风湿性关节炎的灵敏度分别为：81．08％，32．45％，43．24％，62．16％。RF，抗RA33抗体，CRP及ANA诊断各疾病组的特异度分别为：93．33％，93．33％，90．00％，96．67％。ENA的检出率各组间均较低。结论对间质性肺炎患者进行RF，抗RA33抗体，CRP，ANA，ENA联合检测，对于疾病的进展、病因分析、指导治疗和改善预后均具有重要实用价值。

Objective To explore the clinical significance of combined detection of RF,AntI-RA33 antibody,CRP and ANA with ENA in diagnosis and treatment of usual interstitial pneumonia （UIP） and correlate disease. Methods To adopt the serum anti-RA33 antibody was detected using double antibody sandwich ELISA;and using the serum C-reactive protein （CRP） and rheumatoid factor（RF） levels were measured by the immunonephometry. Antinuclear antibodies and anti ENA antibodies were measured by indirect immunofluorescenes technique and Western blot,to determine the level of in 32 cases usual interstitial pneumonia with patients, 37 cases rheumatoid arthritis （RA） with patients, 30 cases usual pneumonia with patients and 30 healthy people. Results The level of RF in patients with UIP compared with RA were significantly difference （P〈0. 01）. The level of CRP in patients with UIP compared with healthy people control group had significantly difference（P〈0. 01）. The level of anti-RA33 antibody in patients with UIP compared with healthy people control group between had markable difference （P〈0. 05） ;The level of anti-RA33 antibody the each disease group compared with the each disease group had no notable difference（P〉0. 05）. The sensitivity of the RF,anti-RA33 antibody,CRP and ANA to diag- nosis of UIP：34.38% ,25.00% ,56.25% and 78. 13%. The sensitivity of the RF,anti-RA33 antibody,CRP and ANA to diagnosis of usual pneumonia ：10. 00% ,6. 67% ,80. 00% and 16.67%. The sensitivity of the four to RA：81.08% ,32.45%, 43.24% and 62.16 %. While the specific was：93.33 %, 93.33 %, 90. 00% and 96.67 %. The positive rate of ENA were low in each disease group. Conclusion These clinical characteristics confirm and etiological factor that there are clinical differences UIP. To explore the clinical significance of combined detection of RF,anti-RA33 antibody,CRP and ANA with ENA combined detection in diagnosis and treatment of usual interstitial pneumonia （UIP）. It is useful may provide help for treating,predicting procession and long-term survival in the diagnosis of the disease.