磁珠酶联免疫分析和流式细胞仪检测强直性脊柱炎患者HLA—B27比较

Comparison of IMS-ELISA and FCM of HLA-B27 with AS Patients

目的探讨磁珠酶联免疫分析（immunomagnetic separation and enzyme-linked immunosorbent assay，IMS-ELISA）法检测人类白细胞抗原B27（human leukocyte antigen BZ7，HLA-B27）在强直性脊柱炎（ankylosing spondylitis，AS）临床诊断中的应用价值。方法同时用IMS-ELISA法和流式细胞仪（flow eytometry，FCM），对2007年5月～2011年2月在孝感市中心医院就诊的320例AS疑似患者进行HLA—B27检测，根据临床确诊结果和检测结果计算两种方法的结果符合率、敏感度、特异度及阴性预测值、阳性预测值。结果临床确诊AS患者178例，非AS患者142位。IMS-ELISA法争FCM检测结果符合率为98．4%。两法的敏感度、特异度及阴性预测值、阳性预测值分着0为0．972，0．989（X2=0．13，P=0．085）；0．951，0．965（x2=0．02，P=0．098）；0．964，0．986（x2=0．03，P=0．079）；0．961，0．972（x2=0．00，P=0．102），两两比较其差异均无统计学意义（P〉0．05）。结论IMS—ELISA法和FCM在检测HLA—B27上比较，结果符合率高，敏感度和特异度也较高，临床适用性相接近，适宜在基层医院推广应用。

Objective To explore the value of immunomagnetic separation and enzyme-linked immunosorbent assay （IMS- ELISA） detecting human leukocyte antigen B27 （HLA-B27）,HLA-B27 in the diagnosis of ankylosing spondylitis （AS）. Methods Simultaneously used IMS-ELISA and flow cytometry（FCM） to detect HLA-B27 in 320 suspected AS patients in our hospital from May 2007 to Feb 2011. Then calculate and contrast the two results＇ correspondence rate,sensltivity, specificity and negative＆ positive predictive value according to the results of the two methods mentioned above. Results The number of the people clinically diagnosed as AS patients was 178 and 142 non-AS patients. The results＇ correspon- dence rate of IMS-ELISA and FCM was 98.4%. Their respective data of sensitivity,specificity and negative ＆ positive predictive value were 0. 972,0. 989（x2=0. 13,P= 0. 085）;0. 951,0. 965 （x2= 0. 02,P=0. 098）;0. 964,0. 986（x2=0. 03,P= 0. 079） and 0. 961,0. 972 （x2= 0. 00, P = 0. 102） respectively, and there was no statistically significant correlation （P 〉 0. 05）. Conclusion In contrast with IMS-ELISA and FCM,their results＇ correspondence rate on HLA-B27 is high,and so it is with sensitivity and specificity. Their clinical applicability approaches with each other. It is could be popularized in basic level hospitals.