三种方法检测抗中性粒细胞胞浆抗体的比较分析

Three methods for detecting antineutrophil cytoplasmic antibodies

目的比较间接免疫荧光法（Indirect immunofluorescence，IIF）、免疫印迹法（Immunoblot，IB）和酶联免疫定量法（ELISA）3种检测方法在检测抗中性粒细胞胞浆抗体时的差异。方法720例观察对象来自2014年12月至2017年1月期间于本院进行临床就诊并住院的患者，收集其血浆分别用3种方法进行抗中性粒细胞胞浆抗体的检测，并比较3种检测方法的差异。结果（1）720例观察对象中IIF—ANCA的阳性率为7．78％（56／720），IB—ANCA的阳性率为4．44％（32／720），ELISA—ANCA的检出率为5．56％（40／720），差异有统计学意义（P〉0．05）。（2）将3种检测方法检测结果进行Kappa一致性分析得出3种方法一致性较强。结论临床进行ANCA检测的3种常用方法中，各有利弊，单一选用1种方法存在一定的漏诊率，建议采用2种或2种以上方法进行ANCA相关疾病的筛检。

Objective To compare the differences between indirect immunofluorescence, immunoblot, and enzyme-linked immunosorbent assay in detecting antineutrophil cytoplasmic antibodies. Method 720 subjects hospitalized into our hospital from December, 2014 to January, 2017 were selected. Their plasma was collected and the antineutrophil cytoplasmic antibodies were detected by the three methods. The differences between the three methods were compared. Results The positive rate by IIF-ANCA was 7.78% （ 56/720 ） , that by IB-ANCA 4.44% （ 32/720 ） , and that by ELISA-ANCA 5.56% （ 40/720 ） , with statistical differences. Kappa consistency analysis of the three detection methods was carried out, and we found that the consistency of the three methods were stronger. Conclusions Among the three commonly used methods for clinical ANCA testing, each method has its advantages and disadvantages, but there is a certain rate of missed diagnosis in the single choice of one method. Therefore, we recommend using two or more than two methods for screening ANCA related diseases in clinical practice.