5590例临床血清标本抗核抗体检测结果分析

Results of detection of antinuclear antibody and its profiles in 5 590 autoimmune disease cases

目的探讨抗核抗体（ANA）和ENA抗体谱在就诊患者中的阳性分布趋势及对自身免疫性疾病（AID）的临床意义。方法采用间接免疫荧光法（IIF）和欧蒙印迹法检测5 590例患者血清标本中的ANA和ENA抗体谱,并对检测结果进行回顾性分析。结果 5 590例患者血清标本中,检出ANA阳性1 256例,阳性率为22.47%。女性阳性率为（1 030/3 645）28.26%,男性阳性率为11.62%（226/1 945）,差异有统计学意义（P〈0.01）。不同年龄组间ANA阳性率,21~50岁组（23.77%）和〉50岁年龄组（23.87%）,与≤20岁年龄组（11.95%）相比较,差异有统计学意义（P〈0.01）。ANA单一型荧光模式以核颗粒型（46.50%）、核均质型（17.83%）等为主,混合型荧光模式以核颗粒型/核均质型（5.25%）为主。5 590例患者血清标本中ENA抗体谱检测阳性者1 288例,阳性率23.04%,大多数为二种或二种以上抗体同时阳性。阳性抗体中阳性率最高的是抗SS-A（45.89%）、抗Ro-52（40.30%）、抗nRNP/Sm（19.33%）等。结论 ANA和ENA抗体谱联合检测具有互补性,可提高自身抗体检出率,对AID的诊断和治疗有重要意义。

Objective To explore the positive distribution trend of the antinuclear antibody（ANA） and ENA antibody in autoimmune disease patients and its clinical significance in patients with autoimmune diseases（AID）. Methods The 5590sera from autoimmune disease were analyzed by detecting the ANA and ENA antibody profile with indirect immunofluorescence（IIF） and immunoblot assay.Results Totally 1 256 ANA positive cases were found out of the 5 590 patients, the positive rate of ANA was 22.47%.The positive rate for female patients and male patients were 28.26% and 17.99%,respectively. The positive rate in female patients was statistically higher than that of male patients（P 0.01）.The positive rate of ANA in the age groups of 21-50 years and 50 years were 23.77%） and 23.87%, higher than that of 20 years old group（11.95%）, showing statistically significant difference（P 0.01）. The major pure fluorescence patterns of ANA were nuclear particle pattern（46.50%） and nuclear homogeneous pattern（17.83%）. the major mix fluorescence patterns of ANA were nuclear particle/nuclear homogeneous model（5.25%）. Of all the 5 590 samples,1 288 cases were positive for the ENA antibody profile, the positive rate was 23.04%. Two or more antibodies might be detected simultaneously. The most frequently occurred antibody were anti-SS-A（45.89%）,anti-ro-52（40.30%）,anti-nRNP/Sm（19.33%）.Conclusion The positive rate of ANA was varied in different age groups and genders. The combined detection of ANA and ENA antibody would be mutually complementary for the diagnosis and treatment of AID.