抗核抗体检测策略研究

Study on Anti-Nuclear Antibody Detection Strategies

目的研究临床检测抗核抗体(ANA)的最佳方案。方法 724例患者样本同时采用间接免疫荧光法(IIF)筛查ANA和线性免疫印迹法(LIA)检测特异性抗核抗体谱(ANAs),结合其临床诊断分为自身免疫性疾病(AID)组和非AID组,将两种方法的结果进行比较分析。结果在IIF和LIA结果不一致的307例患者中,92例确诊为AID,其中IIF(+)LIA(-)有80例,61例诊断为类风湿关节炎(RA);IIF(-)LIA(+)有12例。215例非AID患者中有部分患者的疾病具有相关性,如81例患者为2型糖尿病(DM)和(或)高血压。在IIF和LIA结果一致的417例患者中,IIF(+)LIA(+)有149例,135例确诊为AID,其中54例系统性红斑狼疮(SLE)。结论 AID临床诊断中,IIF筛查ANA应与LIA检测ANAs同时进行,以避免单一方法检测导致AID患者的漏诊。

Objective To look for the optimum solution of anti-nuclear antibodies detection. Methods 724 patients were divided into autoimmune disease （AID） group and non-AID group according to their clinical diagnosis. Serum levels of ANA were determined by indirect immunofluorescence assay （IIF） and using linear immunoblot （IAA） to detect ANAs in these patients,the results from the two methods were compared and analyzed. Results In 307 patients with inconsistent IIF and LIA results, 92 cases were diagnosed as AID,where IIF （＋） LIA（-）in 80 cases, 61 cases were diagnosed as rheumatoid arthritis （RA）, fluorescence mode： 51 cases of nuclear particle type,3 cases for nuclear particle, nuclear homogeneous type; IIF（-） LIA （ -^- ） have 12 cases. In 215 cases of patients with non-AID relevance of the disease in some patients,such as 81 patients were type 2 diabetes mellitus （ DM ） and （ or ） hypertension . In the IIF and LIA results of 417 cases were consistent, IIF （ ＋ ） LIA （ ＋ ） in 149 cases, 135 cases were diagnosed as AID, including 54 cases of systemic lupus erythematosus （SLE）. Conclusion In the clinical diagnosis of AID, IIF screening for ANA should be simultaneously with the LIA ANAs, to avoid the missing diagnosis of AID patients.