酶联免疫吸附法和间接免疫荧光法检测天疱疮抗体的比较

Comparison of Enzyme-linked Immunosorbent Assay Test with Indirect Immunofluorescence in the Diagnosis of Pemphigus

目的比较酶联免疫吸附法(ELISA)和间接免疫荧光法(IIF)检测天疱疮抗体的临床应用价值。方法选择79例天疱疮患者(试验组)和同期排除天疱疮的79例对照人群(对照组),采用间接免疫荧光法(IIF)检测抗表皮棘细胞桥粒抗体,采用酶联免疫吸附法(ELISA)检测抗Dsg1和Dsg3抗体,比较两种检测指标的敏感性、特异性、阳性预测值(PPV)、阴性预测值(NPV)和诊断符合率。结果试验组和对照组抗Dsg1抗体阳性率分别为75.9%(60/79)和2.5%(2/79),抗Dsg3抗体阳性率分别为67.1%(53/79)和3.8%(3/79),抗表皮棘细胞桥粒抗体阳性率分别为82.3%(65/79)和2.5%(2/79)。在天疱疮患者中抗Dsg1抗体的敏感度、特异度、PPV、NPV、诊断符合率分别为75.9%、97.5%、96.8%、80.2%、86.7%。抗Dsg3抗体分别为67.1%、96.2%、94.6%、74.5%、79.7%,抗表皮棘细胞桥粒抗体分别为82.3%、97.5%、97.0%、84.6%、89.9%。3种指标差异无统计学意义(P>0.05)。结论 ELISA法检测抗Dsg1、Dsg3抗体与IIF法检测抗表皮棘细胞桥粒抗体在天疱疮的诊断中有较好的一致性,能相互补充,提高诊断阳性率。

Objective To compare the methods of enzyme-linked immunosorbent assay（ELISA） and indirect immunofluorescence（IIF） in detecting the specific antibodies in the patients with pemphigus. Methods Patients were divided into the experimental group and the control group. The experimental group was diagnosed as pemphigus patients; the control group has been ruled out of pemphigus.Indirect immunofluorescence（IIF） was used to detect resistance to epidermal intercellular desmosome antibodies, enzyme-linked immunosorbent assay（ELISA）was used to detect Dsg1 and Dsg3, counting the sensitivity, specificity, positive predictive value and negative predictive value of each antibody, evaluating comprehensively and analyzing the combination of the statistics and the clinical data. Results In the test group and the control group, the positive rates of anti-Dsg1 antibody were 75.9%（60/79） and 2.5%（2/79）, anti-Dsg3 antibody were 67.1%（53/79） and 3.8%（3/79）, anti-epidermal intercellular desmosome antibody were 82.3%（65/79） and 2.5%（2/79）. Among the patients with pemphigus, the sensitivity, specificity, positive predictive value（PPV） and negative predictive value（NPV）, diagnosis rates of anti-Dsg1 antibody were 75.9%、97.5%、96.8%、80.2%、86.7%, of anti-Dsg3 antibody were 67.1%、96.2%、94.6%、74.5%、79.7%, of anti-epidermal intercellular desmosome antibody were 82.3%、97.5%、97.0%、84.6%、89.9%. There was no significant difference between IIF and Dsg1, 3（P0.05）. Conclusion ELISA is used to detect Dsg1 and Dsg3 and IIF was used to detect resistance to epidermal intercellular desmosome antibodies have good consistency in the diagnosis of pemphigus, could complement each other and increase the diagnostic positive rate.