不同检测技术检测抗核抗体对自身免疫性疾病诊断价值研究

Diagnostic value of different detecting technologies in antinuclear antibody in autoimmune disease

目的对不同检测技术检测抗核抗体(ANA)在自身免疫性疾病(AID)中的诊断价值研究。方法收集系统性红斑狼疮(SLE)患者52例,非SLE AID患者97例,非AID患者92例。分别采用酶联免疫吸附(ELISA)法、间接免疫荧光法(IIFA)和线性免疫印迹法(LIA)检测ANA。结果 ELISA法与IIFA法检测ANA在3组受试者中平均符合率为78.8%。ELISA法与IIFA法检测ANA的检测结果呈正相关(r=0.598,P<0.05)。AID组及非AID组均存在ANA检测IIFA+LIA-者,荧光滴度分布均以1∶100为主。AID组及非AID组IIFA+LIA-者荧光模式均以核颗粒型为主,分别占67.44%和54.69%,2组的阳性率差异无统计学意义(P>0.05),但与其他核型相比,差异均有统计学意义(P<0.05)。IIFA-LIA+组中AID患者占73.3%,比例高于非AID组,AID组IIFA-LIA+患者以SSA/Ro60、SSA/Ro52、SSB/La为主要阳性自身抗体,而非AID组IIFA-LIA+患者以anti-Sm、SSA/Ro52、SSB/La、CenpB为主要阳性抗体。结论临床上诊断AID时应注重多指标多方法联合检测。

Objective To evaluate the diagnostic value of different detecting technologies in antinuclear antibody(ANA)in autoimmune diseases(AID).Methods A total of 52 cases of patients with systemic lupus erythematosus(SLE),97cases of patients with AID but without SLE,92 cases of patients without immune diseases were collected in this study.ANA was detected by enzyme-linked immunosorbent assay(ELISA),indirect immunofluorescence(IIFA)method and linear western blot method(LIA).Results Average coincidence rate between ELISA and IIFA method to detect the ANA was 78.8%in the three groups of participants.The result of ANA detected by ELISA method was positively correlated with that of IIFA method(r=0.598,P<0.05).They found that patients with AID and without AID groups both existed the phenomenon of IIFA ANA+LIA ANA-,their fluorescence titers were given priority to with 1∶100.Their fluorescence modes were given priority to with granularity in both AID group(67.44%)and without AID group(54.69%),there was no difference between the two groups(P>0.05),but they were significantly higher than that of other fluorescence modes.At the same time,the study found that patients with IIFA ANA-LIA ANA+were mostly AID patients(73.3%),the ratio was higher than without AID group,among these patients,AID patients were with SSA/Ro60,SSA/Ro52,SSB/La as the main positive autoantibodies,rather than without AID patients with anti-Sm,SSA/Ro52,SSB/La,CenpB as the main positive antibodies.Conclusion It should pay attention to multi-index joint and multi-tests detection when we diagnose autoimmune diseases.