间接免疫荧光法与化学发光法检测抗核抗体的对比分析

Comparison of Indirect Immunofluorescence Assay and CMIA for Detecting Antinuclear Antibodies

目的探讨间接免疫荧光法（IIFA）和化学发光法（CMIA）检测抗核抗体（ANA）的异同。方法确诊为自身免疫性疾病患者血清240例，同时采用IIFA法和CMIA法检测ANA。时两种方法检测结果不符者采用欧蒙印迹法复查抗核抗体谱。结果IIFA法与CMIA法检测240例ANA阳性率分剐为90．83％和78．75％，差异有统计学意义（P〈0．05）；两种检测方法的符合率为77．92％；在53例两种方法检测结果不一致的标本中，41例IIFA（＋）CMIA（-）患者抗核抗体谱阳性率仅为14．63％；而12例IIFA（-）CMIA（＋）患者抗核抗体谱阳性率高达66．67％，差异有统计学意义（P〈0．05）；IIFA不同荧光核型中，“其他型”在两种方法检测符合率方面低于颗粒型、胞浆型、均质型核型（P〈0．05）。结论CMIA法检测总ANA的敏感度低于IIFA法，而CMIA法的特异度优于IIFA法，因此将IIFA法作为ANA的筛查方法，再结合CMIA法检测，可在获得荧光核型信息观察抗体滴度的同时，进一步对ANA进行定量。而且应用两种不同方法学原理的实验互相佐证，还可以战少实验误差，提高检测的准确度。

Objective To compare indirect immunofluorescence assay （IIFA） and chemoluminescence assay（CMIA） for detecting antinuclear antibodies （ANA）. Methods A total of 240 serum samples were obtained from patients with established autoimmune disease,and all samples were used for ANA detection by both IIFA and CMIA. In cases where discrepancy occurred in the results by the two methods,extractable nuclear antigens were detected using immunoblotting. Results The positivity rate of ANA detected by IIFA and CMIA was significantly different（90. 83% and 78. 75% ,respectively,P 〈0. 05）. All of the samples with different ANA results from two methods were detected for ANA profile. Positive rate of ANA profile was 14. 63% in 41 cases with IIFA positive and CMIA negative,while 66.67% in 12 cases with IIFA negative and CMIA positive. The difference was significant （P〈0. 05）. For uncommon patterns,the percent agreement of the two methods was lowered in ANA detection than common patterns. Conclusion IIFA was more sensitive than CMIA in detecting the ANA. IIFA prescreening combined with CMIA can obtain the information of the nuclear pattern and allow the observation of the titer alterations. The combination of two or more testing methods can greatly enhance the accuracy of the results.