间接免疫荧光法与线性免疫印迹法对自身抗体检测结果分析

Analysis of autoantibodies detection between indirect immunofluorescence method and linear western blot method

目的：探讨自身特异性抗体筛查试验间接免疫荧光法（IIF）与确认试验线性免疫印迹法（LIA）检测结果的相关性。方法：用IIF法作为抗核抗体（ANA）的筛查试验,用LIA法作为抗核抗体谱（ANAs）特异性抗体的确认试验,对自身免疫性疾病组（AID）及非AID疾病对照组进行检测分析,并将检测结果分为四组：IIF-ANA＋/LIA＋组,IIF-ANA＋/LIA-组,IIF-ANA-/LIA＋组和IIF-ANA-/LIA-组。结果：1在611例AID组中,IIF-ANA＋/LIA＋336例（55%）,IIF-ANA＋/LIA-116例（19%）,IF-ANA-/LIA＋55例（9%）,IIF-ANA-/LIA-104例（17%）。2在100例非AID组中,IIF-ANA＋/LIA＋2例（2%）,IIF-ANA＋/LIA-7例（7%）,IIF-ANA-/LIA＋3例（3%）,IIF-ANA-/LIA-88例（88%）,总体符合率90%。AID组与非AID组自身抗体的检测结果比较差异有统计学意义。3 IIF-ANA-/LIA＋组中,以抗SSA抗体、抗Ro-52抗体、抗ds-DNA抗体、抗组蛋白抗体、抗Jo-1抗体为主要检测出的阳性自身抗体。AID组IIF-ANA＋/LIA-中,ANA检测核型以均质型、斑点型为主,混合核型以均质斑点型为主,荧光检测滴度以1∶40-1∶320为主;非AID组IIF-ANA＋/LIA-中,核型以斑点型为主,荧光滴度以1∶40-1∶320为主。结论：AID患者可能会出现IIF-ANA检测阳性而LIA-ANAs检测阴性或者IIF-ANA检测阴性而LIAANAs检测阳性,检查除了进行IIF筛查ANA外,还需进行自身抗体谱的特异性抗体确认实验。

Objective：To explore the correlation of the specific antibody results between screening test of IIF and validation test of LIA.Methods：IIF method as ANA screening test,using LIA method as the validation test of ANAs,Analysis the group of AID and the disease control group of not AID,the test results can be divided into four groups：group IIF ANA ＋ /LIA ＋,group IIF ANA ＋ /LIA-,group IIF-ANA- /LIA ＋,group IIFANA-/LIA-.Results：1In 611 cases of AID groups：IIF ANA ＋ /LIA ＋ had 336patients（55%）,IIF ANA＋ /LIA-had 116patients（19%）,IIF ANA-/LIA ＋ had 55cases（9%）,IIF ANA-/LIA-had 104patients（17%）.2In 100 cases of the not AID group：IIF ANA ＋ /LIA ＋ had 2cases（2%）,IIF ANA ＋ /LIA-had 7cases（7%）,IIF ANA-/LIA ＋ had 3cases（3%）,IIF ANA-/LIA-have 88patients（88%）,the overall coincidence rate was 90%.Two groups autoantibodies detection results had significant statistical significance difference.3In the IIF ANA-/LIA ＋ group,there are anti SSA antibody,anti Ro-52 antibody,anti ds-DNA antibody,antihistonesantibody,anti Jo-1antibody as main detected positive autoantibodies.In the AID groups of IIF ANA ＋ /LIA-,ANA detection karyotype was given priority to with homogeneous,spots,and mixed karyotype was given priority to with homogeneous spots type,and the fluorescence detection of antibody titer was given priority to with 1∶40-1∶320;In the not AID group IIF ANA ＋/LIA-,karyotype was given priority to with spot type,the fluorescence detection of antibody titer was given priority to with 1∶40-1∶320.Conclusion：In the clinical test of AID may appear the IIF test positive for the ANA and LIA-ANAs test negative or IIF-ANA test negative and LIA-ANAs test positive.So in the clinical test of AID,in addition to the IIF screening test,you also need to do the confirmation experiment of autoantibodies spectrum simultaneously,so as to avoid a misdiagnosis because ofthe single test.