抗核周因子抗原片的筛选及临床意义

The screening of substrate slides for detection of antiperinuclear factor and clinical significance

目的 分析抗核周因子 (APF)对类风湿性关节炎 (RA)尤其是对早期RA诊断价值 ,并探讨制备APF抗原片的规律性。方法 从 15 2例不同供体中颊黏膜取材制备核周因子抗原片 ,分别对早期RA、典型RA、非RA的结缔组织病、正常对照共 4组对象检测APF ;同时检测抗角质蛋白抗体 (AKA)、类风湿因子 (RF)。结果 只有 5 0 %的供体颊黏膜上皮适宜做APF的抗原片。以 1∶2 0为阳性阈值 ,APF的阳性率分别为 :早期RA 73.3% ;典型RA 6 3.3% ;非RA的结缔组织病组 3.3% ;正常对照组 3.3%。RA组明显高于对照组 ;APF与AKA、RF均有相关性。结论 APF抗原的选择与性别无相关性 ;结缔组织病人和健康人之间亦无差异。

Objective To evaluate the diagnostic value of antiperinuclear factor (APF) for rheumatoid arthritis (RA), especially for the early stage and explore the regularity of preparation for the antigen substrate slides.Method Buccal mucosa cells from 152 donors were collected for making antigen substrate slides. APF was detected in the subjects of four groups: typical RA, atypical RA, miscellaneous rheumatic diseases and healthy controls.Results Only approximately 50% of the buccal mucosa was suitable for preparation of substrate. When a titer of 1:20 as the threshold value, the positive rate of APF was 73.3% in atypical RA, 63.3% in typical RA, 3.3% in both the two other groups.The positive rate of RA group was significantly higher than that of other groups.The positive APF was correlated with rheumatoid factor (RF) and antikeratin antibody (AKA).Conclusion The buccal mucosa for preparation of substrate was unrelated with gender of the donor and no matter whether they were healthy or patients. APF is a valuable marker for diagnosis of RA, especially for the early stage of RA.