两种方法检测系统性红斑抗核抗体的对比分析

Comparative analysis on two methods of IIF and IBT to detect SLE antinuclear antibodies

目的通过间接免疫荧光法(IIF)和免疫印迹法(IBT)对系统性红斑狼疮(SLE)患者和健康检测人员作对比分析,探讨两种方法对系统性红斑狼疮(SLE)的临床应用价值。方法分别采用IIF和IBT对88例SLE患者和30例健康体检人员的15种抗核抗体(AVA)进行测定。结果 IIF检测SLE患者ANA的阳性率为97.7%(86/88),其荧光染色核型主要为核颗粒型、核均质型、胞质颗粒型和混合型。IBT检测结果显示,SLE患者ANA的阳性率为90.9%(80/88),SLE患者中主要检测出抗双链DNA抗体(dsDNA)、抗sm、抗ss-A、抗nRNP/Sm、抗核小体抗体,以及少量抗组蛋白抗体及抗核糖体P蛋白抗体。健康体检人员两种方法检测均为阴性。结论抗核抗体的IIF法筛选易导致以抗(SSA)为主要抗体或低浓度抗AMA-M2抗体患者的ANA假阴性,而IBT法因检测的抗体不全面也无法取代ANA的IIF法检测。临床实际工作中两种ANA的检测方法不能相互取代,应联合应用。

Objective To compare the detection results of indirect immunofluorescence（IIF） and immunoblotting test（IBT） in systemic lupus erythematosus（SLE） patients and healthy persons and to investigate the value of two methods to diagnose SLE.Methods IIF and IBT were used to detect 15 kinds of antinuclear antibodies in 88 cases of SLE and 30 healthy persons for physical examination.Results The positive rate of antinuclear antibody（ANA） in SLE cases was 97.7%（86/88） for IIF,the fluorescent staining models were mainly nuclear particle type,nuclear homogeneous type and plasma particles type.IBT results showed that the positive rate of ANA in SLE cases was 90.9%（80/88）,which were mainly anti-dsDNA,anti-sm,anti-ss-A,anti-nRNP/sm,antinucleosome antibody,and a few antihistone antibody and anti-ribosomes P antibody.Conclusion IIF method for screening ANA can easily cause false negative ANA in the patients with anti-SSA as the main antibody or low concentration anti-AMA-M2 antibody,while IBT does not replace IIF for detect ANA due to detecting antibodies incompletely.In clinical practical work,the two testing methods of ANA should not replace each other and should be jointly applied