抗核抗体检测在自身免疫性疾病的临床应用

Clinical application of antinuclear antibodies in autoimmune diseases

目的探讨抗核抗体(ANA)在自身免疫性疾病(AID)中的临床意义。方法选取符合AID诊断标准的患者2055例,采用间接免疫荧光法对患者血清标本进行ANA检测,分析ANA的阳性率、核型及滴度的变化。结果 ANA滴度AID患者以1:160为主,对照组以1:80为主。AID检测患者中,ANA阳性率为80%,与对照组比较有显著性差异(P<0.01),以系统性红斑狼疮的ANA阳性率为最高。ANA荧光模型结果系统性红斑狼疮、干燥综合症、类风湿关节炎患者以斑点型为主,自身免疫性肝炎患者以核均质型及核斑点性为主。结论不同AID患者检测ANA阳性率和滴度有差异,检测ANA应重视ANA滴度的价值。ANA荧光模型种类较多,不同的荧光模型表示不同的靶抗原,特别是一些特殊的荧光模型,对AID的诊断有较大的临床意义。

Objective To discuss the clinical significance of anti-nuclear antibody （ANA） in treatment of autoimmune diseases （AID）. Methods 2 055 patients up to the diagnosis standards were selected. The ANA in serum of patients was measured by indirect immunofluorescence. The positive rate, karyotype and titer of ANA were analyzed in the above AID. Results The titer of ANA in AID patients group was 1 ： 80 while I ： 160 in the control group. ANA positive rate of AID patients group was 80%, and its difference with control group had statistical significance （P 〈0.01）. The highest rate was in systemic lupus erythematosus （SLE） patients. Fluorescence patterns of ANA statistics were spot-type based for SLE, drying syndrome, rheumatoid arthritis patients. The homogenous and the nuclear core spots were mainly for autoimmune hepatitis patients. Conclusion The positive rate and tiler of ANA are different among various AID patients. More attention should be paid to the titer value of ANA in the ANA test. Because more and more types of ANA fluorescence patterns are found, and different models represent different fluorescent target antigen. In particular, some special fluorescent models play an important role in the diagnosis of AID.