强直性脊柱炎患者抗核抗体检测结果及临床意义分析

Analysis of antinuclear antibody detection results and clinical significance in patients with ankylosing spondylitis

目的分析强直性脊柱炎(AS)患者抗核抗体检测结果,探讨抗核抗体检测在AS患者分类管理中的临床应用价值。方法选取该院2018-2019年明确诊断为AS的患者453例为研究对象,其中AS合并其他自身免疫性疾病(AID)患者12例。采用间接免疫荧光法检测抗核抗体,免疫印迹法检测抗核抗体谱。采用多因素Logistic回归分析12例AS合并其他AID患者的危险因素。结果453例AS患者中,抗核抗体阳性139例,阳性率为30.68%。12例AS合并其他AID患者,抗核抗体阳性11例,阳性率为91.67%。在抗核抗体阳性检测结果中,女性阳性率明显高于男性,差异有统计学意义(χ^(2)=10.44,P<0.01)。AS患者抗核抗体核型以核颗粒型(45.32%)为主;抗核抗体阳性的AS患者整体滴度中位数为1∶100;抗核抗体滴度≥1∶320患者占18.71%,其抗核抗体谱检测中特异性抗体检出率达30.77%。多因素Logistic回归分析结果显示,年龄越大、抗核抗体阳性为AS合并其他AID的危险因素(P<0.05)。结论AS患者中30.68%可检出抗核抗体,滴度以1∶100为主,部分患者出现中高滴度,为合并其他AID的表现。应加强抗核抗体阳性且病程较长的中老年AS患者的分类管理,进行长期的医学观察,评估是否并发其他AID。

Objective To analyze the results of antinuclear antibody detection in patients with ankylosing spondylitis(AS),and to explore the clinical application value of antinuclear antibody detection in the classification management of as patients.Methods A total of 453 patients with from 2018-2019 in the hospital as were selected as the research objects,including 12 as patients with other autoimmune diseases(AID).The antinuclear antibody was detected by indirect immunofluorescence and the antinuclear antibody spectrum was detected by Western blotting.The risk factors of 12 AS patients with other AID were analyzed by multivariate Logistic regression.Results Among the 453 AS patients,139 were positive for antinuclear antibodies,with a positive rate of 30.68%.11 of 12 AS patients with other AID were positive for antinuclear antibodies,with a positive rate of 91.67%.In the antinuclear antibody positive test results,the positive rate of women was significantly higher than that of men,and the difference was statistically significant(χ^(2)=10.44,P<0.01).The karyotype of anti-nuclear antibodies in AS patients was mainly nuclear granule type(45.32%);the overall median titer was 1∶100;patients with anti-nuclear antibody titer≥1∶320 account for 18.71%,and the detection rate of specific antibodies in the anti-nuclear antibody repertoire detection reached 30.77%.Multivariate Logistic regression analysis showed that grow older and antinuclear antibody positive were risk factors for AS combined with other AID(P<0.05).Conclusion Antinuclear antibodies can be detected in 30.68%of AS patients,and the titer is mainly 1∶100.Some patients have medium-to-high titer,which is a manifestation of other AID.The classification management of middle-aged and elderly AS patients with positive antinuclear antibodies and a long course of disease should be strengthened,and long-term medical observation should be carried out to evaluate whether other AID are complicated.