297例自身免疫性疾病ANA和抗ENA抗体联合检测分析

Analysis of the results of antinuclear antibody and anti-ENA antibodies for 297 patients of autoimmune diseases with IIF and biochip technology

目的分析其中ANA表达阳性而抗ENA抗体表达阴性的样本的检验学特征及意义。方法对297例样本运用间接免疫荧光法检测ANA,生物芯片技术检测抗ENA抗体,并采用双盲法分析ANA阳性标本的荧光核型。从已知的ANA阳性患者血清中筛选其ENA表达均为阴性的患者血清,比对其荧光核型并进行分析。结果 297例临床标本中,ANA阳性标本数为74例,阳性率为24.9%(74/297)。其主要核型为核浆颗粒型(43例,58.1%)、胞浆颗粒型(9例,12.2%)、核浆点型(9例,12.2%)。在74例ANA阳性标本中,抗ENA抗体为阴性的标本数为13例,占阳性标本的17.6%。13例标本中有11例表现为核浆颗粒型,占84.6%;1例表现为胞浆颗粒型,占7.7%;1例表现为核浆点型,占7.7%。结论在ANA阳性同时抗ENA抗体表达为阴性的患者血清中,核浆颗粒型明显高于胞浆颗粒型与核浆点型在ANA标本中的阳性率,并且远大于核浆颗粒型在抗ENA抗体表现为阳性的ANA阳性标本中的比例(52.5%),差异有统计学意义(χ2=5.018,P<0.05)。在抗ENA抗体表现为阴性的ANA阳性标本中,荧光核型表现为核浆颗粒型有其自身特有的临床意义有助于筛选发现抗ENA抗体以外的新自身抗体。

Objective To analyze the clinical features and significance of the samples which the expression of ANA is positive and the expression of anti‐ENA antibody is negative .Methods Detect ANA and anti‐ENA antibody of all the 297 samples by indi‐rect immunofluorescence method and biological chip technology ,repectively .And analyze the fluorescence karyotype of ANA posi‐tive specimens with double‐blind method .Screen the samples which anti‐ENA antibody express negative from ANA positive sam‐ples .Compare and analyze the fluorescent karyotype .Results Of all the 297 samples ,74 cases were positive for ANA ,the positive rate was 24 .9% (74/297) .The majority of patterns were speckled pattern (43 cases ,58 .1% ) ,cytoplasmic granular pattern (9 ca‐ses ,12 .2% ) ,and antibody to centromere antigen(9 cases ,12 .2% ) ,respectively .In 74 cases of ANA positive specimens ,ENA anti‐body the negative rate of ENA antibody is 17 .6% (13/74) .Of the 13 cases ,the most frequently occurred pattern was the speckled pattern(11 cases ,84 .6% ) ,the rate of cytoplasmic granular pattern and antibody to centromere antigen was 7 .7% (1/13) respec‐tively .Conclusion In the serum samples which express ANA positive and ENA antibody negative ,the rate of speckled pattern is significantly higher than the other patterns ,and far more than the rate of speckled pattern in the samples which express ENA anti‐body and ANA positive (52 .5% ) (chi‐square= 5 .018 ,P< 0 .05) ,with statistical significance .We consider the speckled pattern samples be in favour of discovering new antibodys of this kind of serum sample .