7708例血清抗核抗体和抗核抗体谱联合检测的相关性分析

Correlation analysis of antinuclear antibodies and antinuclear antibody spectrum in 7 708 cases

目的分析7 708例血清抗核抗体(ANA)和抗核抗体谱(ANAs)检测结果,探讨两者间关系。方法采用间接免疫荧光法(IIF)和免疫印迹法(LIA)分别检测ANA和ANAs,对其结果进行相关性分析。结果 7 708例标本总阳性率为34. 01%,男性阳性率为26. 45%,女性为40. 19%;ANA(+) 2 070例(26. 86%),ANAs(+) 1 398例(18. 14%),其中ANA(+)/ANAs (+) 847例(10. 99%),ANA (+)/ANAs (-) 1 223例(15. 87%),ANA (-)/ANAs (+) 551例(7. 15%),ANA(-)/ANAs(-) 5 087例(66. 00%),与IIF-ANA法比较,LIA-ANAs法检测灵敏度为40. 92%、特异度为90. 23%、总符合率为76. 99%。ANA(+)标本中,阳性率随着ANA滴度的增高而降低,而ANAs阳性率随着滴度增高而升高。ANA (-)/ANAs (+)标本中,抗Ro-52抗体的阳性率最高(27. 13%)。结论IIF-ANA与LIA-ANAs 2种方法存在一致性和差异性,不可替代,联合检测可综合诊断自身免疫病,以免漏诊、误诊。

Objective To analyze the results of antinuclear antibodies( ANA) and antinuclear antibody spectrum( ANAs) and to investigate the relationship between the them. Methods ANA and ANAs were detected by indirect immuneofluorescent assay( IIF) and western blotting( LIA),then the results were conducted for correlation analysis. Results The total positive rate of 7 708 cases was 34. 01%,the positive rate of male was 26. 45%,the positive rate of female was 40. 19%. In the 7 708 specimens,2 070 cases were ANA( +)( 26. 86%),1 398 cases were ANAs( +)( 18. 14%),847 cases were ANA( +)/ANAs( +)( 10. 99%),1 223 cases were ANA( +)/ANAs(-)( 15. 87%),551 cases were ANA(-)/ANAs( +)( 7. 15%),5 087 cases were ANA(-)/ANAs(-)( 66. 00%). Compared with IIF-ANA,the sensitivity,specificity and total coincidence rate of LIA-ANAs were respectively 40. 92%,90. 23% and 76. 99%. Among the ANA( +) specimens,the positive rate decreased with increasing ANA titer,while the positive rate of ANAs increased with increasing titer. Among the ANA(-)/ANAs( +) specimens,the anti-Ro-52 antibody had the highest positive rate( 27. 13%). Conclusion There are consistency and difference between the two methods of IIF-ANA and LIA-ANAs. It is irreplaceable. Combined detection can comprehensively diagnose autoimmune diseases,so as to avoid missed diagnosis and misdiagnosis.