临床标本抗核抗体4188份检测结果回顾性分析

Retrospective analysis of antinuclear antibody test results of 4188 specimens

目的探讨抗核抗体（ANA）常见类型在四川地区自身免疫性疾病（AID）患者中的分布趋势及临床价值。方法采用免疫印迹法对2011年1月至2013年9月4 188份疑似AID患者的临床标本进行ANA常见15种类型（抗NRNP、抗SM、抗SS-A、抗RO-52、抗SS-B、抗SCL-70、抗PM-SCL、抗JO-1、抗CENP、抗PCNA、抗ds-DNA、抗组蛋白、抗核小体、抗核糖体P蛋白及抗AMAM2）的检测,统计其分布情况,并对性别、年龄及季节进行分组,采用χ2检验进行统计学分析。结果 （1）在4 188份标本中,ANA阳性率为28.8%,AID阳性率为7.2%。在确诊的303例AID患者中,干燥综合征（SS）患者抗SS-A阳性率（75.4%）最高,依次为抗RO-52（61.5%）及抗SS-B（20.5%）;系统性红斑狼疮（SLE）患者抗SS-A阳性率（76.8%）最高,依次为抗RO-52（64.2%）及抗ds-DNA（41.1%）;混合性结缔组织（MCTD）患者抗RO-52阳性率（42.5%）最高,其次为抗SS-A（41.1%）及抗NRNP（26.0%）;类风湿性关节炎（RA）患者抗SM阳性率（65.4%）最高,其次为抗SS-A（38.5%）。SS是四川地区最常见的AID,依次为SLE、MCTD及RA等。（2）在4 188例疑似AID患者中,女性AID阳性率（11.0%）显著高于男性（1.5%）,差异有统计学意义（χ^2=136.44,P〈0.05）;年龄组中18～45岁组阳性率最高（8.4%）,〈18岁组最低（2.1%）,差异有统计学意义（χ2=8.92,P〈0.05）;季度组中第4季度阳性率最高（8.6%）,第1季度最低（6.2%）,差异有统计学意义（χ^2=3.47,P〈0.05）。结论四川地区AID患者ANA常见类型分布可能与年龄、季节及性别相关,这在AID的诊断方面有重要价值。

Objective To explore the distribution trend and clinical value of antinuclear antibody（ANA） in patients with autoimmune diseases（AID） in Sichuan region. Methods Immunoblotting test was employed among 4 188 specimens with suspected AID from January 2011 to September 2013 to determine the 15 common types of ANA（anti-NRNP,anti-SM,anti-SS-A,anti-RO-52,anti-SS-B,anti-SCL-70,anti-PM-SCL,anti-JO-1,anti-CENP,anti-PCNA,anti-ds-DNA,anti-histone,anti-nucleosome,antiribo-somal P protein and anti-AMAM2）,to summarize the statistical distribution and divide according to the gender,age and season. The results were analyzed statistically by χ2test. Results（1）In 4188 specimens,the positive rates of ANA and AID were28.8% and 7.2% respectively. In 303 patients with confirmed AID,the positive rate of anti-SS-A of patients with sicca syndrome（SS） was highest（75.4%）,followed by anti-RO-52（61.5%） and anti-SS-B（20.5%）;the positive rate of anti-SS-A of patients with systemic lupus erythematosus（SLE） was the highest（76.8%）,followed by anti-RO-52（64.2%） and anti-ds-DNA（41.1%）;the positive rate of anti-RO-52 of patients with mixed connective tissue disease（MCTD） was the highest（42.5%）,followed by anti-SS-A（41.1%） and anti-NRNP（26.0%）;the positive rate of anti-SM of patients with rheumatoid arthritis（RA） was the highest（65.4%）,followed by anti-SS-A（38.5%）. SS was the most common AID in Sichuan region,followed by SLE,MCTD and RA.（2） In 4 188 patients with suspected AID,the positive rate of AID of female（11.0%） was obviously higher than that of the male（1.5%） with statistically significant difference（χ2=136.44,P〈0.05）;the positive rate of the patients with the age from 18 to 15 years old was the highest（8.4%）,while the patients less than 18 years old were the lowest（2.1%）,and the difference had statistical significance（χ^2=8.92,P〈0.05）;the fourth quarter had the highest positive rate（8.6%）,while the first quarter had the lowest（6.2%）,and the difference was statistically significant（χ^2=3.47,P〈0.05）. Conclusions The common distribution of ANA of AID patients in Sichuan region might be related with age and season,which has important value for AID diagnosis.