11452例抗核抗体检测结果及临床意义探讨

Antinuclear antibody detection results in 11452 cases and clinical significance

目的探讨抗核抗体(ANA)检测结果及其在自身免疫性疾病中的临床意义。方法收集2015年11月至2016年8月到该院就诊的11 452例自身免疫性疾病(AID)患者,同时选取同期体检健康者142例作为对照组,采用间接免疫荧光法检测ANA。计算ANA的阳性率,统计ANA阳性的自身免疫性疾病患者的相关临床信息和实验室特征。结果在11 452例患者中ANA阳性率为44.14%,其中男性阳性率30.72%,女性阳性率51.68%,女性ANA阳性率明显高于男性,差异具有统计学意义(χ2=470.213,P<0.05)。不同年龄组(≤20岁、>20~<50岁、≥50岁)的阳性率差异也有统计学意义(χ2=104.960,P<0.05)。AID组和对照组阳性率差异有统计学意义(P<0.05)。AID组中的系统性红斑狼疮、干燥综合征、混合性结缔组织病患者以核颗粒型为主,原发性胆汁性肝硬化患者以着丝点型、核膜型和胞质型为主。结论不同性别和年龄组患者之间ANA阳性率存在明显差异。不同AID患者ANA滴度和荧光模型也不同,可以指导临床进一步进行特异性自身抗体的检测,对临床诊断有重要的意义。

Objective To explore the anti-nuclear antibodies（ANA）detection results and their clinical significance in autoimmune diseases（AID）.Methods A total of 11 452 patients in the hospital during November 2015 to August 2016 were collected and performed the ANA detection by adopting the indirect immunofluorescence.The positive rate of results was calculated.Then the related clinical information and laboratory characteristics in the positive patients with AID were statistically analyzed.The positive rate comparison adopted the chisquare test.Results In 11 452 cases,the positive rate of ANA was 44.14%,51.68%in female and 30.72%in male.The positive rate in female was significantly higher than that in male,the difference was statistically significant（χ~2=470.213,P〈0.05）.The ANA positive rate also had statistically significant difference among different age groups（≤20years old,〉20-〈50years old,≥50years old,χ~2=104.960,P〈0.05）.The positive rate had statistical difference between the two group（P〈0.05）.In the AID group,the nuclear speckled pattern was predominant in the patients with systemic lupus erythematosus（SLE）,sissa syndrome（SS）and mixed connective tissue disease（MCTD）,and centromere pattern,nuclear membrane pattern and cytoplasma pattern were predominant in the patients with primary billiary cirrhosis（PBC）.Conclusion The positive rate of ANA is statistically different in different gender and age.Different AID patients have different titers and fluorescence models,which can guide clinic to further conduct specific autonomous antibody detection and has an important significance to clinic.