核仁型抗核抗体在自身免疫性疾病中的临床意义

Clinical significance of nucleolar antinuclear antibodies associated with the nucleolar immunofluorescence pattern in autoimmune disease

目的 探讨核仁型抗核抗体(ANA)在相关疾病中的临床意义。方法 该研究为回顾性研究,收集2017年1月至2022年5月该院就诊患者临床样本71 780例,采用间接免疫荧光法检测临床标本的ANA,统计核仁型ANA在临床就诊患者中的阳性率,以及核仁型ANA阳性自身免疫性疾病(AID)患者的相关临床信息和实验室特征。结果 在71 780例患者ANA常规检测中,ANA阳性的有16778例,阳性率为23.37%。其中核仁型有1708例,占所有ANA常规检测的2.38%,在ANA阳性者中的比例为10.18%。>20~<50岁组和≥50岁组中不同性别患者核仁型ANA阳性率比较差异有统计学意义(P<0.05),而≤20岁组中不同性别患者核仁型ANA阳性率比较差异无统计学意义(P>0.05)。不同年龄组女性的核仁型ANA阳性率比较差异有统计学意义(P<0.05),其中以>20~<50岁组女性核仁型ANA阳性率为最高。不同年龄组男性核仁型ANA阳性率比较差异无统计学意义(P>0.05)。ANA阳性率以风湿免疫科患者为最高(70.35%),但核仁型ANA阳性主要见于生殖医学中心(12.90%)、呼吸内科(12.40%)及神经内科(11.29%)等科室,且科室间的阳性率差异有统计学意义(P<0.05)。1708例核仁型ANA阳性者中,420例做了ANA滴度,包括34例AID患者,386例非AID患者。核仁阳性滴度在非AID患者与AID患者之间的差别无统计学意义(P>0.05)。结论 核仁型是ANA阳性者中的常见荧光模式,在ANA阳性者中存在性别和年龄差异;核仁型ANA阳性率和滴度在不同AID疾病中均存在差异。联合其他免疫功能指标检测,有助于早期鉴别诊断AID。

Objective To explore the clinical significance of nucleolar antinuclear antibodies(ANA)in related diseases.Methods This study was a retrospective study.Clinical samples of 71780 patients who visited the hospital from January 2017 to May 2022 were collected.Indirect immunofluorescence was used to detect ANA in clinical samples.Statistical analysis was conducted on the positivity rate of nucleolar ANA in clinical patients,as well as the relevant clinical information and laboratory characteristics of patients with autoimmune diseases(AID)with nucleolar ANA positivity.Results Among 71780 patients who underwent routine ANA testing,16778 were positive for ANA,with a positive rate of 23.37%.Among them,there were 1708 cases of nucleolar type,accounting for 2.38%of all routine ANA tests,and the proportion of ANA positive cases was 10.18%.There was a statistically significant difference in the positive rate of nucleolar ANA between patients of different genders in the>20-<50 year old group and the≥50 year old group(P<0.05),while there was no statistically significant difference in the positive rate of nucleolar ANA between patients of different genders in the≤20 year old group(P>0.05).There was a statistically significant difference in the positivity rate of nucleolar ANA among women of different age groups(P<0.05),among them,the highest positive rate of nucleolar ANA was found in women aged between 20 and 50 years old.There was no statistically significant difference in the positive rate of nucleolar ANA among males of different age groups(P>0.05).The positivity rate of ANA was the highest among patients in the Department of Rheumatology and Immunology(70.35%),but nucleolar ANA positivity was mainly seen in departments such as Reproductive Medicine Center(12.90%),Respiratory Medicine(12.40%),and Neurology(11.29%),and the difference in positivity rates between departments was statistically significant(P<0.05).Out of 1708 nucleolar ANA positive individuals,420 underwent ANA titers,including 34 AID patients and 386 non AID patients.There was no statistically significant difference in nucleolus positive titers between non AID patients and AID patients(P>0.05).Conclusion The nucleolus type is a common fluorescence pattern in ANA positive individuals,and there are gender and age differences in ANA positive individuals.The positive rate and titer of nucleolar ANA vary among different AID diseases.Combined with other immune function indicators,and it is helpful for early differential diagnosis of AID.