820例抗核抗体阳性临床标本检测结果回顾性分析

Retrospective analysis of 820 anti-nuclear antibody positive clinical specimens

目的分析我室抗核抗体阳性标本荧光核型与抗双链DNA、抗核抗体谱结果之间的相关性。方法分别使用间接免疫荧光法和免疫印迹法检测抗核抗体和抗核抗体谱,使用酶联免疫吸附法检测抗双链DNA,对阳性结果,间接免疫荧光法复检,分析不同荧光核型对应的特征性抗原谱结果。结果总计820例抗核抗体单项阳性标本,核颗粒型为最常见核型(53.29%),其次是胞浆颗粒型(14.63%)和着丝点型(12.93%)。单项阳性标本中抗双链DNA或抗核抗体谱阳性的比率为73.9%。437例核颗粒型中,最常见抗体为抗SSARo52(55.15%)、抗SSA(57.89%)、抗SSB(21.05%)和抗nRNP(26.77%);120例胞浆颗粒型中,最常见抗体为抗AMA M2(30%);106例着丝点型中,最常见抗体为抗CENP B(98.11%);70例核均质型中,最常见抗体为抗核小体(32.86%)和抗组蛋白(21.43%)抗体;以上与非该核型组相比差异有统计学意义(P<0.01)。结论我室"抗核抗体常规套餐"通过联合检测,有助于综合判断与预后观察,但仍可能存在遗漏,应综合患者的临床表现与其他实验室检查结果。

Objective To analyze the correlation between the fluorescent karyotype of anti-nuclear antibody positive samples in our laboratory and the anti-double-stranded DNA and anti-nuclear antibody spectrum results. Methods Indirect immunofluorescence and immunoblotting wereused to detect antinuclear antibodies and antinuclear antibody profiles, respectively. Detection of anti-double-stranded DNA using enzyme-linked immunosorbentassay, positive results, indirect immunofluorescence retest, The characteristic antigen spectrum results corresponding to different fluorescentkaryotypes were analyzed. Results 820 anti-nuclear antibody single positive samples, nuclear particle type is the most common karyotype（53.29%）, followed by cytoplasmic granule type （14.63%） and centromere type （12.93%）. The ratio of anti-double-stranded DNA or anti-nuclear antibodyspectrum positive in single positive samples was 73.9%. Among the 437 nuclear particle types, the anti-SSARo52 was 55.15%, the anti-SSAwas 57.89%, the anti-SSB was 21.05% and the anti-nRNP was 26.77%. Among the 120 cytoplasmic granules, the most common antibody was anti-AMA M2 （30%）; among 106 cases of centromere, the most common antibody was anti-CENP B （98.11%）. Among the 70 nuclear homogenizationtypes, the most common antibodies were anti-nucleosome （32.86%） and anti-histone （21.43%） antibodies. The above differences were statisticallysignificant compared with the non-nuclear group （P〈0.01）. Conclusion The ＂Anti-nuclear antibody routine package＂ in our room is helpful forcomprehensive judgment and prognosis through joint testing, but there may still be omissions. The clinical manifestations of patients should be combinedwith other laboratory tests.