视神经脊髓炎特异性抗体三种检测方法比较

Comparison of three anti-aquaporin 4 antibody detection methods in neuromylitis optica

目的 评价组织间接免疫荧光检测（IIF）、细胞免疫荧光（CBA）及ELISA 3种不同检测视神经脊髓炎（NMO）特异性抗水通道蛋白4（AQP4）抗体的方法。方法 NMO 29例、多发性硬化（MS）23例、健康志愿者50例，分别采用IIF、CBA及ELISA方法检测血清中的抗AQP4抗体，比较各种方法诊断NMO的敏感性和特异性以及阳性结果的一致性。结果 3种方法检测的抗AQP4抗体诊断NMO的敏感性CBA法（72.4％）＞IIF法（62.1％）＞ELISA法（51.7％）；特异性CBA法（100％）＞ ELISA法（98.6％） ＞IIF法（97.3％）。采用Kappa检验评估各种检测方法一致性，CBA、IIF、ELISA 法均具有较好的一致性，其中CBA法与ELISA法检测一致性最好（P＜0.01）。结论 检测抗AQP4 抗体以CBA法敏感性和特异性最佳，CBA与ELISA法阳性结果具有较好的一致性。

Objective To evaluate three methods of detecting anti-aquaporin 4 （AQP4） antibody in neuromylitis optica （NMO）, including indirect immunofluorescence assay organization （IIF）, cell immunofluorescence method （CBA） and ELISA.Methods The patients were divided into NMO group （n =29）, multiple sclerosis （MS） group （n = 23）,and healthy controls group （n = 50）.IIF, CBA and ELISA were used in 3 groups to detect serum anti-AQP4 antibody.The sensitivity and specificity as well as the consistency of positive results were compared.Results In the aspect of the sensitivity of the three antiAQP4 antibody to diagnosis NMO, CBA （72.4%） 〉 IIF （62.1%） 〉 ELISA （51.7%） ; in the aspect of specificity, CBA （100.0%） 〉 ELISA （98.6%） 〉 IIF （97.3%）.Kappa testing and evaluation method showed that the three detection methods were all in good consistency, particular in CBA and ELISA （P 〈0.01）.Conclusions CBA method showed a highest specificity and sensitivity in all these three anti-AQP4 antibody detection methods.CBA and ELISA are in better consistency of positive results.