抗核抗体和抗核抗体谱检测诊断自身免疫性疾病在西藏地区的应用

Detection of autoimmune diseases by anti-nuclear antibody and anti-nuclear antibody spectrum in Tibet

目的研究抗核抗体和抗核抗体谱检测诊断自身免疫性疾病在西藏地区的临床应用。方法采用间接免疫荧光法(indirect immunofluorescence,IIF)筛查西藏自治区人民医院2018年2481例临床送检血清标本的抗核抗体(anti-nuclear antibodies,ANA),同时采用线性免疫印迹法(linear immunoblotting,LIA)检测抗核抗体谱(anti-nuclear antibody spectra,ANAs)。结果 2481例标本中,ANA(+)ANAs(+)标本350例,占14.11%;ANA(+)ANAs(-)标本421例,占16.97%;ANA(-)ANAs(+)标本61例,占2.46%;ANA(-)ANAs(-)标本1 649例,占66.47%。ANA与ANAs检测结果总体符合率为80.57%,两种方法检测结果的差异具有统计学意义(χ~2=672.677,P<0.01)。结论 IIF检测ANA应作为自身免疫实验室基础实验,同时应开展ANA和ANAs检测和滴度报告,在有条件有能力的情况下,临床首诊时应对疑似患者同时进行ANA和ANAs检测,并对血清学检测阴性的疑似患者和高危人群长期或定期随访。

Objective To study the clinical application of anti-nuclear antibody and anti-nuclear antibody spectrum in the diagnosis of autoimmune diseases in Tibet. Methods Indirect immunofluorescence(IIF) was used to screen the anti-nuclear antibodies(ANA) of 2481 clinical specimens in our hospital in 2018, and the anti-nuclear antibody spectra(ANAs) were detected by linear immunoblotting(LIA). Results Among the 2481 specimens, 350 ANA(+)ANAs(+) specimens accounted for 14.11%, 421 specimens of ANA(+)ANAs(-) accounted for 16.97%, 61 specimens of ANA(-)ANAs(+) accounted for 2.46%, and 1649 ANA(-) ANAs(-) specimens accounted for 66.47%. The overall agreement rate between ANA and ANAs was 80.57%. The difference between the two methods was statistically significant(χ~2=672.677, P<0.01). Conclusions The IIF test of ANA should be used as the basic experiment of autoimmune laboratory. The laboratory should carry out the detection and titer report of ANA and ANAs at the same time. Suspected and high-risk patients with negative serological tests results should be regularly detected and followed up.