血清抗髓过氧化物酶抗体、抗蛋白酶3抗体和抗肾小球基底膜抗体联合检测在自身免疫性血管炎中的临床意义

Clinical Significance of Combined Detection of Serum Anti-Myeloperoxidase Antibody,Anti-Proteinase 3 Antibody and Anti-Glomerular Basement Membrane Antibodies in Autoimmune Vasculitis

目的探讨检测血清抗髓过氧化物酶抗体(MPO抗体)、抗蛋白酶3抗体(PR3抗体)和抗肾小球基底膜抗体(GBM抗体)对自身免疫性血管炎(AAV)的临床意义。方法符合诊断标准的AAV患者分为3组:微型多血管炎组(microscopic polyangiitis,MPA)11例、肉芽肿性多血管炎组(granulomatosis with polyangiitis,GPA)11例和嗜酸性肉芽肿性血管炎组(eosinophilic granulomatosis with polyangiitis EGPA)11例,体检健康者50例作为对照组,采用间接免疫荧光法测定血清MPO抗体,PR3抗体,GBM抗体。结果 AAV各组与对照组比较,血清MPO抗体水平显著升高(P<0.05);MPA组和GPA组与对照组比较,血清PR3抗体水平显著升高(P<0.05);MPA和EGPA与对照组比较,血清GBM抗体水平显著升高(P<0.05)。结论 MPO抗体、PR3抗体、GBM抗体的联合检测对AAV的类型诊断有参考价值。

Objective To investigate the clinical significance of detecting serum anti-myeloperoxidase antibody （ MPO antibody） , anti-proteinase 3 antibody （ PR3 antibody） and anti-glomerular basement membrane antibody （ GBM antibody） on autoimmune vasculitis （AAV）. Methods AAV patients which met the diagnostic standard were divided into 3 groups：11 cases in microscopic polyangiitis group （ microscopic polyangiitis, MPA） , 11 cases in granulomatous with polyangiitis group （ granulo-matosis with polyangiitis, GPA） , and 11 cases in eosinophilic granulomatous with polyangiitis group （ eosinophilic granulomatosis with polyangiitis, EGPA）. 50 cases with healthy physical examination were selected as the control group. Indirect immunofluorescence was used to measure the serum MPO antibody, PR3 antibody, and GBM antibody. Results Compared with the control group, the serum MPO antibody levels were significantly higher （ P 〈0. 05 ） in each AAV group. Compared with the control group, the serum PR3 antibody levels of MPA group and GPA group were significantly increased （P〈0. 05）. Compared with the control group, the serum GBM antibody levels of MPA group and EGPA group were significantly increased （P〈0. 05）. Conclusion The combined detection of MPO antibody, PR3 antibody and GBM antibody has a reference value for the diagnosis of AAV.