抗桥粒芯蛋白抗体对天疱疮的临床诊断价值

The Clinical Diagnostic Value of Anti-desmoglein Antibody in Pemphigus

目的研究天疱疮患者血清中抗桥粒芯蛋白(desmoglein,Dsg)1和抗Dsg3抗体水平在天疱疮的临床诊断价值。方法采用酶联免疫吸附试验(ELISA)测定62例天疱疮患者血清中抗Dsg1和抗Dsg3抗体水平;间接免疫荧光法(IIF)测定天疱疮抗体Ig G水平。结果 62例天疱疮患者中抗Dsg1抗体或抗Dsg3抗体任一阳性共50例,阳性率80.65%,与间接免疫荧光法(IIF)相比两种方法差异无统计学意义(P>0.05)。因此抗Dsg抗体具有和IIF一样的临床诊断价值。34例寻常型天疱疮(PV)中抗Dsg3抗体阳性或抗Dsg1和抗Dsg3抗体均阳的28例,阳性率82.35%;24例落叶型天疱疮(PF)中抗Dsg1抗体阳性的为20例,阳性率83.33%。可见抗Dsg3抗体是PV的鉴别诊断指标,抗Dsg1抗体是PF的鉴别诊断指标。此外,通过对治疗前后抗Dsg1抗和Dsg3抗体的滴度水平的检测发现,抗Dsg1和抗Dsg3抗体还可作为天疱疮治疗监测的指标。结论采用ELISA方法测定天疱疮患者外周血抗Dsg1抗体和抗Dsg3抗体,方法简便,对患者创伤小,有一定的诊断和鉴别诊断价值。另外,抗Dsg1抗体和抗Dsg3抗体还可作为监测天疱疮治疗效果的指标。

Objective To study the clinical diagnostic value of anti-desmoglein （Dsg） 1 and anti-Dsg3 antibody levels in pemphigns. Methods Serum anti-Dsgl and anti-Dsg3 antibody levels were measured by Enzyme-linked immunosorbent assay （ELISA） in62 patients with pemphigus. Indirect immunofluorescence assay （llF） was used to measure IgG levels in patients with pemphigus. Results Either anti-Dsgl or anti-Dsg3 antibody was positive in 50 of 62 cases with pemphigus. The positive ratio was 80. 65%. There was no significant difference （X^2 = 0. 06, P 〉 0. 05 ） compared with the method of IIF. The anti-Dsg antibody showed the same clinical diagnostic value as IIF. A total of 28 in 34 cases of pemphigus vulgaris were positive in anti- Dsg3 antibody or both anti-Dsgl and anti-Dsg3 antibody and the positive ratio was 82. 35%. A total of 20 in 24 cases of pemphigus foliaceus were positive in anti-Dsgl antibody and the positive ratio was 83.33%. An- ti-Dsg3 was a visible indicator for the differential diagnosis of PV and anti-Dsgl antibody was an index on the differential diagnosis of PF. In addition, anti-Dsgl and anti-Dsg3 antibody could be used as the monitoring indicators of pemphigus treatment by monitoring the anti-Dsgl and anti-Dsg3 antibody level before and after treatment. Conclusion Anti-Dsgl antibody and anti-Dsg3 antibody in peripheral blood of patients with pemphigus could be measured by the method of ELISA. This method was simple, less traumatic to the pa- tient and it showed certain value on both diagnosis and differential diagnosis of pemphigus. In addition, anti- Dsgl and anti-Dsg3 antibody could be used as the monitoring indicators of pemphigns treatment.