炎症性肠病患者血清学抗体与临床表型的相关性研究

Correlative Study of Serum Antibodies and clinical phenotype of Inflammatory Bowel Disease

目的探讨血清p-ANCA、ASCA、PAB和GAB与IBD临床表型的可能相关性。方法间接免疫荧光法检测32例溃疡性结肠炎(UC)、47例克罗恩病(CD)患者血清p-ANCA、ASCA、GAB和PAB的表达,用χ~2检验分析抗体与IBD临床表型的关系。结果诊断时年龄>40岁的CD患者p-ANCA阳性率高于≤40岁者(25.0%vs0.0%,P <0.05);穿透型、狭窄型、非狭窄非穿透型CD患者ASCA阳性率分别为60.0%、20.0%、9.1%(P <0.05);女性CD患者GAB阳性率高于男性(76.5%vs 40.0%,P <0.05)。未发现p-ANCA、ASCA、PAB、GAB与UC的临床表型、PAB与CD的临床表型有关。结论 ANCA阳性的CD患者起病时间晚,狭窄型或穿孔型CD患者ASCA阳性率较高,女性CD患者GAB阳性率较高,p-ANCA、ASCA、PAB、GAB与UC的临床表型无关。

Objective To study the possible correlation between serumal perinuclear anti-neutrophil cytoplasmic antibody（p-ANCA）, anti-saccharomyces cerevisiae antibody（ASCA）,anti-intestinal goblet cell antibody（GAB） and anti-pancreatic antibody（PAB） and the clinical phenotype of inflammatory bowel disease（IBD）. Methods The serum levels of p-ANCA, ASCA, GAB and PAB in 32 patients with UC, 47 patients with CD were detected by indirect immunofluorescence assay. Pearson Chi-square test was employed for analyzing the correlations of these serum antibodies with IBD. Results The positive percentage of p-ANCA in CD patients 〉40 age at diagnosis was higher than that in CD patients≤40 age（25.0% vs 0.0%, P =0.026）. The percentages of ASCA positivity were different among CD patients with internal penetrating（60.0%）, with structuring（20.0%）, and with non-penetrating non-stricturing behavior（9.1%, P =0.042）. The positive-GAB rate in female CD patients was higher than in male（76.5% vs 40.0%, P =0.016）. There was no statistically significant association between p-ANCA, ASCA, PAB or GAB and clinical feature in patients with UC, as well as PAB in CD patients. Conclusions The positive p-ANCA rate was relatively higher in senior patients. The percentage of positive-ASCA was higher in CD with internal stricturing or with penetrating behavior, as well as GAB in female CD patients. Expression of p-ANCA, ASCA, PAB and GAB was not associated with UC clinical phenotype.