内镜下诊断炎症性肠病联合四种抗体检测的临床意义

Endoscopic diagnosis of inflammatory bowel disease in combination with four kinds of antibody detection of clinical significance

目的为探讨内镜下诊断炎症性肠病联合测定血清中抗中性粒细胞胞浆抗体(ANCA)、抗酿酒酵母菌抗体(ASCA)、抗小肠杯状细胞抗体(GAB)、抗胰腺腺泡抗体(PAB)对临床诊断的意义。方法结肠镜下诊断20例溃疡性结肠炎(UC组)、10例克罗恩病(CD组)、10例肠道疾病组患者,5例健康对照组分别用间接免疫荧光法测血清中的ANCA、ASCA、IGA、PAB水平。结果 4组中AN CA的阳性率分别为60%(12例)、20%(2例)、10%(1例)、0%(0例);ASCA的阳性率分别为20%(2例)、50%(5例)、10%(1例)、0%(0例);GAB的阳性率分别为10%(1例)、10%(1例)、10%(1例)、0%(0例);PAB的阳性率分别为5%(1例)、10%1例)、0%(0例)、0%(0例);4组抗体联合检测阳性率分别为80%(16例)、90%(9例)、30%(3例)、0%(0例)。结论内镜下诊断炎症性肠病联合ANCA、ASCA、GAB、PAB检测可提高诊断率,同时可作为鉴别溃疡性结肠炎和克罗恩病的一种非创伤性诊断方法。

Objective To explore the significance of endoscopic diagnosis about inflammatory bowel disease in the combined determination of serum anti-neutrophil cytoplasmic antibody（ANCA）, anti-saccharomyces cerevisia antibody（ASCA）, anti-intestinal goblet cell antibody（GAB）, anti-pancreatic（PAB）. Methods 20 cases of ulcerative colitis（UC）, 10 cases of crohn＇s disease（CD）,10 cases with intestinal disease was diagnosed under colonoscopy and chosen as study groups, 5 cases of healthy cases was chosen as control group. Serum ANCA, ASCA, IGA, PAB level in all cases were measured respectively by indirect immunofluorescence method.Results Positive rate of ANCA in four groups were 60%（12 cases）, 20%（ 2 cases）, 10%（ 1 case）, 0%（n = 0）; ASCA positive rate was 20%（2 cases）, 50%（5 cases）, 10%（1 case）, 0%（n = 0）; IGB of the positive rate was 10%（1 case）, 10%（1 cases）, 10%（1case）0%（n = 0）; PAB positive rate was 5%（1 case）, 10%（1 cases）, 0%（n = 0）, 0%（n = 0）; joint detection antibody positive rate in four groups was 80%（16 cases）, 90%（9 cases）, 30%（3cases）, 0%（n = 0）respectively. Conclusion Endoscopic diagnosis of inflammatory bowel disease combined with ANCA, ASCA, IGA, PAB detection can improve the diagnostic rate, at the same time it can be used as a kind of no traumatic diagnostic method to identify ulcerative colitis and crohn＇s disease.