抗核抗体荧光模型与滴度在自身免疫性疾病中的临床分析

Clinical analysis on the antinuclear antibody fluorescence model and titer in autoimmune diseases

目的探讨抗核抗体(ANA)荧光模型、滴度差异在自身免疫性疾病(AID)的临床价值。方法选取2019年6月至2020年6月深圳市福田区风湿病专科医院就诊的153例AID患者(AID组)及92例非AID患者或健康者(非AID组),回顾性分析两组ANA阳性率、ANA模型、滴度分布情况及差异,以及系统性红斑狼疮(SLE)患者ANA滴度与抗ds-DNA抗体浓度的关系。结果AID组ANA阳性率为83.0%(127/153),非AID组阳性率为13.0%(12/92),差异有统计学意义(P<0.05);AID组中ANA模型以核颗粒型、均质型、混合型为主;SLE模型以核颗粒型为主,其ANA滴度与抗ds-DNA抗体浓度呈正相关(r=0.538,P<0.05);强直性脊柱炎(AS)、类风湿关节炎(RA)、未分化结缔组织病(UCTD)患者ANA滴度(中位数)均为1∶320,非AID患者ANA滴度(中位数)为1∶100,其余AID患者ANA高滴度(中位数)≥1∶1000。结论AID患者ANA阳性率和滴度不一样,不同ANA荧光模型提示不同疾病。SLE患者ANA滴度与抗ds-DNA抗体呈正相关。非AID者ANA亦可阳性,但滴度一般较低。

Objective To investigate the clinical value of antinuclear antibody(ANA)fluorescence model and titer difference in autoimmune diseases(AID).Methods AID patients(the AID group,n=153)and non-AID patients or healthy people(the non-AID group,n=92)admitted to Shenzhen Futian Hospital for Rheumatic Diseases from June 2019 to June 2020 were selected.The ANA positive rate,ANA model,titer distribution and difference between the two groups,as well as the correlation between ANA titer and anti-ds-DNA concentration in patients with systemic lupus erythematosus(SLE)were analyzed retrospectively.Results The positive rate of ANA in the AID group was 83.0%(127/153),and that in the non-AID group was 13.0%(12/92),with statistically significant difference(P<0.05).In the AID group,the antinuclear antibody model was mainly nuclear granule type,homogeneous type and mixed type.The SLE model was mainly nuclear granule type,and its ANA titer was positively correlated with anti-ds-DNA antibody(r=0.538,P<0.05).The median ANA titers of ankylosing spondylitis(AS),rheumatoid arthritis(RA)and undifferentiated connective tissue disease(UCTD)were all 1∶320,the median ANA titers of the non-AID patients were 1∶100,and the median ANA high titers of other AID patients were≥1∶1000.Conclusion The positive rate and titer of ANA in AID patients are different,and different ANA fluorescence models suggest different diseases.ANA titer in SLE patients is positively correlated with anti-ds-DNA antibody.ANA can also be positive in non-AID patients,but the titer is generally low.