间接免疫荧光法检测抗核抗体与免疫印迹法检测抗核抗体谱结果的分析比较

The Study of Antinuclear Antibody and Its Specific Antibody Test results with the Clinical Relations

目的比较间接免疫荧光法(IIF)筛查抗核抗体(ANA)与免疫印迹法(LIA)检测抗核抗体谱(ANA谱)特异性抗体结果的一致性,分析二者的相互关系及临床意义。方法2012年6月~2012年12月期间在中国中医科学院西苑医院风湿病科住院的503例患者,分析其ANA与ANA谱检测的一致性。将ANA与ANA谱的联合检测结果分为ANA+/ANA谱+、ANA+/ANA谱-、ANA-/ANA谱+、ANA-/ANA谱-四组,比较各组间的差异,并分析各类型自身免疫性疾病(AID)患者的分布情况。最后探讨AID患者ANA与ANA谱非一致时所检测出的核型及特异性抗体的特点。结果ANA与ANA谱检测结果无显著统计学差异,两者符合率为77.27%,不符合率为22.73%。ANA+/ANA谱+,ANA+/ANA谱-,ANA-/ANA谱+三组统计显示AID与非AID患者的概率不相同;ANA-/ANA谱-组AID与非AID患者的概率相同。结论ANA与ANA谱联合检测比单一检测时阳性预测值(PPV)提高,假阴性率(FNR)减低。ANA+/ANA谱+,ANA+/ANA谱-,ANA-/NA谱+三组对AID疾病有鉴别意义,而ANA-/ANA谱-组对AID无鉴别意义。

Objective To compare the indirect immunofluorescence(IIF) screening of antinuclear antibodies(ANA) and line immunoblot assay(LIA) detection of specificity antinuclear antibodies(ANAs), analysis of the relationship and clinical significance. Methods From June 2012 to December 2012 in China during the period of Xiyuan hospital of traditional Chinese medicine academy of sciences, rheumatism, 503 people in the hospital, we analysis of the differences between the three different forms of detection methods. According to the test results, all of the patients are divided into four groups, and in patients with four groups of ANA and its ANAs test results and clinical diagnosis results are comparative analysis, statistics a discrepancy arises between the two detection methods of all kinds of patients with autoimmune diseases(AID) distribution. Results There was no statistically significant difference between the two methods. Consistent rate was 77.27%, the Non-consistent rate consistent rate was 17.61%. ANA+/ANA +, ANA+/ANA – and ANA-/ANA + groups show that the probability of AID and non AID patients is not the same; while ANA-/ ANA- group show that the probability of AID and non AID patients is not the same. Conclusion No statistically significant difference between the two methods, and the combined detection than the single detection PPV increased, FNR decreased. ANA+/ANA +, ANA+/ANA- and, ANA-/NA+ groups can identify he diagnosis of AID disease, and ANA-/ ANAgroups can not identify the diagnosis of AID.