281例蛋白尿患者血清的ANCA抗体谱检测阳性率观察

Observation on the positive rate of ANCA test in 281 patients with albuminuria

目的探讨ANCA检测在蛋白尿患者中的阳性率及临床应用。方法应用IIF检测ACNA总抗体、p-ANCA和c-ANCA;ELISA检测抗MPO和抗PR3。结果281例蛋白尿患者中16例ANCA总抗体阳性,阳性率为5.69%,其中p-ANCA阳性13例和c-ANCA阳性3例,阳性率分别为4.62%、1.07%;MPO抗体阳性2例,PR3抗体阳性3例,阳性率分别为0.71%、1.07%。905例其它AID中检出39例总ANCA阳性,阳性率4.31%。SLE 661例,SS 164例、SSC 65例、AIH 15例,pANCA抗体阳性率分别为3.03%、1.83%、1.54%及0%;MPO抗体阳性率分别为1.51%、1.21%、1.54%及0%。结论蛋白尿患者ANCAS检测具有一定阳性率,检测不仅广泛应用于AAV的诊断、治疗及病情预后评估,也可作为蛋白尿患者早期诊断SLE、RA,特别是AAV灵敏度及特异性较好的检测指标。

Objective To discuss the positive rate and clinical application of ANCA test in patients with albuminuria.Methods Total antibody of ACNA,p-ANCA and c-ANCA were detected by IIF.Anti-MPO and anti-PR3 were detected by ELISA.Results Among 281 patients with albuminuria,16 cases were positive for ANCA total antibody,the positive rate was 5.69%,among which 13 cases were positive for p-ANCA and three cases were positive for c-ANCA,the positive rate was 4.62%and 1.07%,respectively.MPO antibody was positive in two cases and PR3 antibody was positive in three cases,the positive rates were 0.71%and 1.07%,respectively.Among 905 cases of other AID,39 cases were positive for total ANCA,with a positive rate of 4.31%.There were 661 cases of SLE,164 cases of SS,65 cases of SSc and 15 cases of AIH.The positive rates of pANCA antibody were 3.03%,1.83%,1.54%and 0%,respectively.The positive rates of MPO antibody were 1.51%,1.21%,1.54%and 0%,respectively.Conclusions ANCAS detection has a certain positive rate in patients with albuminuria,which is not only widely used in the diagnosis,treatment and prognosis assessment of AAV,but also can be used as an early diagnosis of SLE and RA in patients with albuminuria,especially AAV detection index with good sensitivity and specificity.