金华地区8007例自身抗体检测结果分析

Analysis of 8007 cases autoantibodies detection results in Jinhua

目的探讨自身抗体在临床就诊患者中的阳性分布趋势与自身免疫性疾病（AID）发生的相关性,对临床诊断的价值。方法采用间接免疫荧光法（IIF）和印迹法,对2012年4月-2013年4月在金华中心医院就诊的8 007例患者的血清标本进行ANA、ENA和ds-DNA检测。结果在8 007份检测标本中,ANA阳性率为17.5%,其中男性为9.1%,女性为20.5%,二者差异有统计学意义（χ2=137.36,P〈0.01）。不同年龄组间ANA阳性患者的阳性率也有统计学意义（≤20岁组为14.7%、21岁～49岁组为19.2%、≥50岁组为18.0%,χ2=18.47,P〈0.01）。AID患者荧光模型分析表明,单一荧光模型以颗粒型（36.8%）和均质型（26.4%）为主,混合荧光模型以颗粒型/浆细胞型（5.8%）为主。ANA阳性患者1 404例,其中符合AID诊断的患者815例。结论临床就诊患者中ANA阳性率在不同性别、年龄组间差异有统计学意义;不同AID患者均会出现特异或相对特异的自身抗体。ANA与ENA抗体谱联合检测对AID患者诊断及鉴别诊断具有重要意义。

Objective To investigate the correlation between the positive distribution of autoantibodies in patients with clinical diagnosis and the occurrence of autoimmune diseases（ AID） and the value of clinical diagnosis. Methods From 2012 April to2013 October in Jinhua center hospital,8 007 patients＇ serum samples of ENA and ANA and ds- DNA was detected by indirect immunofluorescence（ IIF） and Western blotting. Results Of the 8 007 specimens,the positive rate of ANA was 17. 5%,the positive rate for female patients and male patients were 20. 5% and 9. 1%,and the difference between them was statistically significant（ χ2= 137. 36,P〈0. 01）. ANA positive patients in different age groups was statistically significant（ ≤20 years old,14. 7%; 21- 49 years old,19. 2%; ≥50 years old,18. 0%,χ2= 18. 47,P〈0. 01）. AID patients fluorescence mode analysis showed that the major single fluorescence mode were particle type（ 36. 8%） and homogenous type（ 26. 4%）,the major mixed fluorescence mode was particle type and plasma cell type（ 5. 8%）. ANA positive patients were 1 404 cases,815 cases were diagnosed by AID. Conclusion The positive rate of ANA in clinical treatment was statistically significant in different gender and age groups. In patients with different AID,there will be specific or relatively specific autoantibodies. The combined detection of ANA and ENA antibody spectrum is of great significance in the diagnosis and differential diagnosis of AID patients.