抗中性粒细胞胞浆抗体检测对系统性血管炎的临床价值

Anti-neutrophil cytoplasmic antibody determination for systemic vasculitis

目的探讨抗中性粒细胞胞浆抗体(ANCA)检测对系统性血管炎的临床意义。方法应用间接免疫荧光法(IIF)检测13 866例患者血清ANCA,采用酶联免疫吸附试验(ELISA)检测抗髓过氧化物酶(MPO)抗体和抗蛋白酶3(PR3)抗体。结果 13 866例患者共检出ANCA阳性318例,阳性率为2.29%。其中男性患者检出135例(2.07%)、女性患者检出183例(2.50%),2个组差异无统计学意义(χ~2=2.650,P>0.05)。不同年龄组患者间ANCA阳性率差异有统计学意义(χ~2=28.978,P<0.01),且男、女性患者各自不同年龄组间ANCA阳性率差异亦有统计学意义(χ~2=54.550,P<0.01;χ~2=17.800,P<0.01)。p-ANCA和c-ANCA2种荧光核型及靶抗原分布差异有统计学意义(χ~2=86.524,P<0.01)。结论 ANCA的检测对血管炎及自身免疫性疾病的诊断和治疗极为重要,临床工作者应注重ANCA在系统性血管炎及自身免疫性疾病中的检测。

ObjectiveTo evaluate the role of anti-neutrophil cytoplasmic antibody（ANCA） determination for systemic vasculitis. MethodsIndirect immuno？uorescence（IIF） was performed to determine serum ANCA in 13 866 patients,and enzyme-linked immunosorbent assay（ELISA） was used to determine anti-myeloperoxidase（MPO） antibody and anti-protease 3（PR3） antibody. ResultsAmong the 13 866 patients,there were 318 positive cases of ANCA,with the positive rate of 2.29%. There were 135（2.07%） males and 183（2.50%） females,and there was no statistical signi？cance between the 2 groups（χ2=2.650,P〉0.05）. The difference of the ANCA positive rate with different ages had statistical signi？cance（χ2=28.978,P〈0.01）. The positive rate of ANCA between males and females in different age groups had statistical significance（χ2=54.550,P〈0.01;χ2=17.800,P〈0.01）. The p-ANCA and c-ANCA and target antigen distribution had statistical significance（χ2=86.524,P〈0.01）. ConclusionsANCA is potential in the diagnosis and treatment of vasculitis and autoimmune diseases,especially for ANCA-associated systemic vasculitis.