抗核抗体谱检测对自身免疫性疾病诊断的价值

The value of antinuclear antibody spectrum detection in the diagnosis of autoimmune disease

目的探讨抗核抗体谱(ANAs)对自身免疫性疾病(AID)诊断中的临床意义。方法对153例自身免疫性疾病患者及50例健康体检者,分别进行间接免疫荧光法与免疫印迹法检测ANA及抗核抗体谱,分析结果。结果 153例自身免疫性疾病患者中视疾病不同有1项或多项抗体阳性,抗ds-DNA与抗核小体抗体对SLE特异性较高,抗nRNP滴度是MCTD的高度特异性标志且具有较高敏感度(83.33%),抗SCL-70抗体是进行性系统性硬化症的特异性抗体,抗M2抗体高滴度对原发性胆汁性肝硬化特异性较高。血清中ANA检出率较高的AID有SLE(86.84%)、SS(82.61%)、PM/DM(80.00%)、MCTD(50.00%),在筛查诊断上起重要作用。正常对照组未检出抗核抗体,与AID组差异有统计学意义(P<0.01)。结论 ANA谱对自身免疫性疾病诊断具有较好特异性与敏感性,结合ANA结果对临床诊疗有重要意义。

Objective To explore the clinical significance of antinuclear antibody spectrum detection in the diagnosis of autoim- mune disease. Methods The antinuclear antibodies （ANA） and antinuclear antibodies spectrum （ANAs） in 153 cases of auto- immune disease patients and 50 healthy controls were measured by indirect immunofluorescence and immunoblotting assay, and the results were analyzed. Results There were different detection rates of ANA assay in accord with different autoimmune dis- eases of 153 patients. Anti - ds - DNA and Anti - Nucleosomes had high specificity in detecting SLE, Anti - nRNP had high specificity and sensitivity（83.33% ） in detecting MCTD, Anti -SCL- 70 had high specificity in detecting PSS, Anti -AMA M2 with high titers had high specificity in detecting PBC. The high detection rate was found in SLE group of SLE（ 86.84% ）, SS（82.61% ）, PM/DM（80.00% ） and MCTD（50.00% ）, which had significance in screening diagnosis. In the healthy con- trol group there is no any ANA detected, which was significantly different from AID group（P 〈 0.01 ）. Conclusion The ANAs results have good specificity and sensitivity in diagnosing AID, which is of great clinical significance when analyzing with ANA profile.