Enzyme-linked immunosorbent assay of 3 Screen Islet Cell Autoantibody in patients with autoimmune thyroid disease

BACKGROUND In recent years,the emergence of multiplex technology that can simultaneously measure multiple anti-islet autoantibodies has become particularly valuable for the staging and early diagnosis of immune-mediated type 1 diabetes(T1D).While it has been established that 20%-30%of T1D patients suffer from autoimmune thyroid disease(AITD),there is limited available data regarding the presence of anti-islet autoantibodies in AITD patients.Among commercially available anti-islet autoantibodies,glutamic acid decarboxylase 65 autoantibodies(GADAs)are often the first marker measured in general clinical practice.AIM To investigate the frequency of anti-islet autoantibodies in AITD patients.METHODS Our study involved four hundred ninety-five AITD patients,categorized into three distinct groups:AITD with T1D(n=18),AITD with phenotypic type 2 diabetes(T2D)(n=81),and AITD without diabetes(n=396),and the enzyme-linked immunosorbent assay(ELISA)was employed to determine the frequencies of 3 Screen Islet Cell Autoantibody(3 Screen ICA),GADA,insulinoma-associated antigen-2 autoantibodies(IA-2As),and zinc transporter 8 autoantibodies(ZnT8As)within these groups.RESULTS The frequency of 3 Screen ICA in AITD patients with T1D,T2D,and those without diabetes were 88.9%,6.2%,and 5.1%,respectively,with no significant difference seen between the latter two groups.Notably,the frequency of 3 Screen ICA was 11.1%higher in AITD patients with T1D,1.3%higher in AITD patients with T2D,and 1.1%higher in AITD patients without diabetes compared to GADA,respectively.Furthermore,12.5%,20.0%,and 20.0%of the 3 Screen ICA-positive patients were negative for GADA.Additionally,1.3%of the AITD patients who tested negative for 3 Screen ICA in both the AITD with T2D and non-diabetic AITD groups were found to be positive for individual autoantibodies.Among the 3 Screen ICA-positive patients,there was a significantly higher proportion of individuals with multiple autoantibodies in AITD patients with T1D compared to those without diabetes(37.5%vs 5.0%,P<0.05).However,this proportion was similar to that in AITD patients with T2D(20.0%).Nevertheless,there was no significant difference in 3 Screen ICA titers between AITD patients with T1D and those without diabetes(436.8±66.4 vs 308.1±66.4 index).Additionally,no significant difference in 3 Screen ICA titers was observed between Graves’disease and Hashimoto’s thyroiditis in any of the groups.CONCLUSION Our findings reveal that some AITD patients without diabetes exhibit 3 Screen ICA titers comparable to those in AITD patients with T1D.Thus,3 Screen ICA outperforms GADA in identifying latent anti-islet autoantibody-positive individuals among AITD patients.

Clinical Phenotype of Japanese Patients with Dermatomyositis—Classification Based on Dermatomyositis-Specific Autoantibodies

Objectives: To correlate the precise specificity of autoantibodies in Japanese dermatomyositis (DM) patients with their clinical phenotypes. Methods: Serum samples from 94 adult DM patients (67 with classical DM and 27 with clinically amyopathic dermatomyositis, CADM) were screened for autoantibodies using immunoprecipitation assays. Patients with antibodies against aminoacyl transfer RNA synthetase (ARS), Mi-2 or who had other autoantibodies were assessed for clinical symptoms and laboratory findings. Results: Sera from 27 of 94 DM patients (29%) were found to have anti-ARS antibodies. Nineteen (20%) had anti-CADM-140/MDA5, 5 (5%) had anti-Mi-2, and 8 (6%) had anti-p155/TIF1-γ. Anti-MJ/NXP-2 was not found in our series of adult DM. Seventeen patients with anti-ARS had fever and 22 had arthritis and interstitial lung disease (ILD), compatible with a diagnosis of anti-ARS syndrome. Seventeen of 19 (89%) with anti-CADM-140/MDA5 had ILD, 16 (84%) of whom developed rapidly progressive ILD (RP-ILD). Four of 5 (80%) with anti-Mi-2 had heliotrope rash and/or Gottron’s sign/papules, and 2 (40%) had V-sign and/or shawl-sign rash, whereas no ILD or malignancy was detected. As seen with anti-Mi-2-positive patients, a low frequency of ILD (13%) was found in patients with anti-p155/TIF1-γ but 6 of 8 (75%) had malignancy during their course. The frequency of ILD was significantly higher in patients with anti-ARS or anti-CADM-140/MDA5 compared with anti-Mi-2 or anti-p155/TIF1-γ (81% and 89%, respectively). It should be noted that anti-CADM-140/MDA5-positive patients suffered significantly more RP-ILD compared to patients with anti-ARS (84% vs. 7%, P < 0.0001). On the other hand, anti-p155/TIF1-γ positive patients had a significantly higher rate of malignancy compared with anti-ARS-, anti-CADM-140/MDA5-and anti-Mi-2-positive patients (75% vs. 7%: P = 0.0004, 5%: P = 0.0006, 0%: P = 0.02, respectively). Conclusions: These results indicate that in addition to antibodies previously identified as specific for DM, autoantibodies newly found in these patients are useful for stratifying them into clinical subgroups.

Profile of Autoantibodies and Clinical Symptoms in Guinean Patients with Connective Tissue Diseases

Connective tissue diseases (CTDs) are Autoimmune diseases (AIDs) characterized by the appearance of autoantibodies, which are diagnostic markers. Investigations of these autoantibodies play a major role in the management of several autoimmune diseases. The objective of this study was to describe the profile of anti-ENA antibodies according to the clinical symptoms of mixed CTDs in Conakry teaching Hospital. We performed a cross-sectional study during six months. A total of 20 patients was recruited and we measured antibodies using the ELISA technique. The mean age of our patients was 36.5 years, with a predominance of females. Cutaneous and rheumatological signs were the main clinical manifestations. SLP was the most frequent CTDs;the threshold of ENA antibodies positivity was higher in scleroderma with and SLP. Anti-ENA identification reveals the frequency of anti-SSA (83.33%), anti-U1RNP (66.66%) and anti-histone (50%) antibodies. Antinuclear antibodies (ANA) react with various components of the cell nucleus. Their detection is of major interest in the diagnosis of CTDs. Our results highlight the importance of determining the specificity of these antibodies to guide differential diagnosis.

Autoantibodies related to ataxia and other central nervous system manifestations of gluten enteropathy

Gluten ataxia and other central nervous system disorders could be linked to gluten enteropathy and related autoantibodies.In this narrative review,we focus on the various neuro-logical manifestations in patients with gluten sensitivity/celiac disease,immunological and autoimmune mechanisms of ataxia in connection to gluten sensitivity and the autoantibodies that could be used as a biomarker for diagnosing and following.We focused on the anti-gliadin antibodies,antibodies to different isoforms of tissue transglutaminase(TG)(anti-TG2,3,and 6 antibodies),anti-glycine receptor antibodies,anti-glutamine acid decarboxylase antibodies,anti-deamidated gliadin peptides antibodies,etc.Most studies found a higher prevalence of these antibodies in patients with gluten sensitivity and neurological dysfunction,presented as different neurological disorders.We also discuss the role of a gluten-free diet on the clinical improvement of patients and also on imaging of these disorders.

Role of biochemical markers and autoantibodies in diagnosis of early-stage primary biliary cholangitis

BACKGROUND Primary biliary cholangitis(PBC)is a chronic progressive autoimmune cholestatic disease.The main target organ of PBC is the liver,and nonsuppurative inflammation of the small intrahepatic bile ducts may eventually develop into cirrhosis or liver fibrosis.AIM To explore the clinical characteristics of early-stage PBC,identify PBC in the early clinical stage,and promptly treat and monitor PBC.METHODS The data of 82 patients with PBC confirmed by pathology at Tianjin Second People’s Hospital from January 2013 to November 2021 were collected,and the patients were divided into stage I,stage II,stage III,and stage IV according to the pathological stage.The general data,serum biochemistry,immunoglobulins,and autoimmune antibodies of patients in each stage were retrospectively analyzed.RESULTS In early-stage(stages I+II)PBC patients,50.0%of patients had normal alanine aminotransferase(ALT)levels,and 37.5%had normal aspartate aminotransferase(AST)levels.For the remaining patients,the ALT and AST levels were mildly elevated;all of these patients had levels of<3 times the upper limit of normal values.The AST levels were significantly different among the three groups(stages I+II vs stage III vs stage IV,P<0.05).In the early stage,29.2%of patients had normal alkaline phosphatase(ALP)levels.The remaining patients had different degrees of ALP elevation;6.3%had ALP levels>5 times the upper limit of normal value.Moreover,γ-glutamyl transferase(GGT)was more robustly elevated,as 29.2%of patients had GGT levels of>10 times the upper limit of normal value.The ALP values among the three groups were significantly different(P<0.05).In early stage,the jaundice index did not increase significantly,but it gradually increased with disease progression.However,the above indicators were significantly different(P<0.05)between the early-stage group and the stage IV group.With the progression of the disease,the levels of albumin and albumin/globulin ratio tended to decrease,and the difference among the three groups was statistically significant(P<0.05).In early-stage patients,IgM and IgG levels as well as cholesterol levels were mildly elevated,but there were no significant differences among the three groups.Triglyceride levels were normal in the early-stage group,and the differences among the three groups were statistically significant(P<0.05).The early detection rates of anti-mitochondria antibody(AMA)and AMA-M2 were 66.7%and 45.8%,respectively.The positive rate of anti-sp100 antibodies was significantly higher in patients with stage IV PBC.When AMA and AMA-M2 were negative,in the early stage,the highest autoantibody was anti-nuclear antibody(ANA)(92.3%),and in all ANA patterns,the highest was ANA centromere(38.5%).CONCLUSION In early-stage PBC patients,ALT and AST levels are normal or mildly elevated,GGT and ALP levels are not elevated in parallel,GGT levels are more robustly elevated,and ALP levels are normal in some patients.When AMA and AMA-M2 are negative,ANA especially ANA centromere positivity suggests the possibility of early PBC.Therefore,in the clinic,significantly elevated GGT levels with or without normal ALP levels and with ANA(particularly ANA centromere)positivity(when AMA and AMA-M2 are negative)may indicate the possibility of early PBC.

Intracranial infection accompanied sweet’s syndrome in a patient with anti-interferon-γautoantibodies:A case report

BACKGROUND Several reports of adult-onset immunodeficiency syndrome have been associated with anti-interferon-gamma(IFN-γ)autoantibodies(AIGAs).However,it is rare to find AIGAs with intracranial infections.CASE SUMMARY In this case study,we report a case of an AIGAs with intracranial infection and hand rashes considered Sweet’s syndrome.The patient presented to our hospital with a persistent cough,a fever that had been going on for 6 mo,and a rash that had been going on for a week.The patient started losing consciousness gradually on the fourth day after admission,with neck stiffness and weakened limb muscles.The upper lobe of the left lung had a high-density mass with no atypia and a few inflammatory cells in the interstitium.Brain magnetic resonance imaging and cerebrospinal fluid suggest intracranial infection.The pathology of the skin damage on the right upper extremity revealed an infectious lesion that was susceptible to Sweet’s disease.It has an anti-IFN-γautoantibody titer of 1:2500.She was given empirical anti-non-tuberculous mycobacterial and antifungal treatments.The patient had no fever,obvious cough,headache,or rash on the hand.She got out of bed and took care of herself following hospitalization and discharge with medicine.CONCLUSION Adults with severe and recurrent infections of several organs should be considered for AIGAs if no other known risk factors exist.AIGAs are susceptible to subsequent intracranial infections and Sweet’s syndrome.

Location-based prediction model for Crohn’s disease regarding a novel serological marker,anti-chitinase 3-like 1 autoantibodies

BACKGROUND Defective neutrophil regulation in inflammatory bowel disease(IBD)is thought to play an important role in the onset or manifestation of IBD,as it could lead to damage of the intestinal mucosal barrier by the infiltration of neutrophils in the inflamed mucosa and the accumulation of pathogens.Like neutrophils in the context of innate immune responses,immunoglobulin A(IgA)as an acquired immune response partakes in the defense of the intestinal epithelium.Under normal conditions,IgA contributes to the elimination of microbes,but in connection with the loss of tolerance to chitinase 3-like 1(CHI3L1)in IBD,IgA could participate in CHI3L1-mediated improved adhesion and invasion of potentially pathogenic microorganisms.The tolerance brake to CHI3L1 and the occurrence of IgA autoantibodies to this particular target,the exact role and underlying mechanisms of CHI3L1 in the pathogenesis of IBD are still unclear.AIM To determine the predictive potential of Ig subtypes of a novel serological marker,anti-CHI3L1 autoantibodies(aCHI3L1)in determining the disease phenotype,therapeutic strategy and long-term disease course in a prospective referral cohort of adult IBD patients.METHODS Sera of 257 Crohn’s disease(CD)and 180 ulcerative colitis(UC)patients from a tertiary IBD referral center of Hungary(Division of Gastroenterology,Department of Internal Medicine,Faculty of Medicine,University of Debrecen)were assayed for IgG,IgA,and secretory IgA(sIgA)type aCHI3L1 by enzyme-linked immunosorbent assay using recombinant CHI3L1,along with 86 healthy controls(HCONT).RESULTS The IgA type was more prevalent in CD than in UC(29.2%vs 11.1%)or HCONT(2.83%;P<0.0001 for both).However,sIgA subtype aCHI3L1 positivity was higher in both CD and UC patients than in HCONT(39.3%and 32.8%vs 4.65%,respectively;P<0.0001).The presence of both IgA and sIgA aCHI3L1 antibodies was associated with colonic involvement(P<0.0001 and P=0.038,respectively)in patients with CD.Complicated disease behavior at sample procurement was associated with aCHI3L1 sIgA positivity(57.1%vs 36.0%,P=0.009).IgA type aCH3L1 was more prevalent in patients with frequent relapse during the disease course in the CD group(46.9%vs 25.7%,P=0.005).In a group of patients with concomitant presence of pure inflammatory luminal disease and colon involvement at the time of diagnosis,positivity for IgA or sIgA type aCH3L1 predicted faster progression towards a complicated disease course in time-dependent models.This association disappeared after merging subgroups of different disease locations.CONCLUSION CHI3L1 is a novel neutrophil autoantigenic target in IBD.The consideration of antibody classes along with location-based prediction may transform the future of serology in IBD.

抗接触蛋白相关蛋白-2抗体相关脑炎临床特征分析

目的 总结抗接触蛋白相关蛋白-2(CASPR2)抗体相关脑炎的临床特征。方法与结果收集2017年8月至2022年8月中山大学附属第三医院诊断与治疗的13例抗CASPR2抗体相关脑炎患者。首发表现:9例表现为边缘系统症状,2例表现为周围神经症状(均为肢体疼痛),1例为小脑性共济失调,1例肢体乏力。抗CASPR2抗体检测:13例患者均进行血清抗CASPR2抗体检测,均呈阳性;10例患者接受脑脊液抗CASPR2抗体检测,5例呈阳性;有3例患者合并其他自身抗体阳性。头部MRI检查:13例患者中2例表现为单侧或双侧颞叶内侧T2-FLAIR成像高信号;2例存在脑微出血灶。治疗:2例仅单纯采用激素治疗,4例仅静脉注射免疫球蛋白,5例则先后接受激素+静脉注射免疫球蛋白治疗,1例仅接受利妥昔单抗治疗,1例先后接受静脉注射免疫球蛋白+激素+蛋白A免疫吸附+利妥昔单抗。随访:进行1~5年的随访,2例失访;1例患者自行停药后复发,经治疗后改良Rankin量表(mRS)评分为零;余10例患者中1例症状未见改善,1例部分症状存在不能正常生活,6例正常生活,2例死亡。结论 抗CASPR2抗体相关脑炎临床特征复杂,血清抗体检测对于明确诊断至关重要。

人红细胞类同种特异性自身抗体的血清学试验分析与研究

目的近年来,实验室临床样本的检测中,类同种特异性自身抗体(以下简称“类抗体”)样本检出率不断增加。抗球蛋白微柱凝集卡技术逐渐普及应用,进一步提高了类抗体检出率。为了研究类抗体实验室检测特点,探讨类抗体输血原则,本文进行了回顾性数据分析,为产生类抗体的患者提供有效的检测方法和临床建议。方法对160名产生类抗体的受检者进行详细的性别、年龄、诊断、血清学试验等回顾性分析。分析实验所得数据,找寻相关规律。结果类抗体最常见特异性为RH血型类抗体,包括类抗-Ce,类抗-Ec和类抗-D等占94.48%。CCDee分型是类抗体受检者最常见分型。血清微柱凝集卡法检测类抗体反应性较强(类抗体计分值最高:7.16分)。血清试管抗球蛋白法反应强度差异性最为显著,鉴别类抗体特异性较好。结论鉴定类抗体特异性比较困难,建议选择多种鉴定方法。微柱凝集卡法检测类抗体的反应性较强,抗球蛋白法鉴别类抗体特异性较好,建议此两种方法联合使用。输血治疗时应尽量避开类抗体特异性,输注相应抗原阴性的红细胞。

玫瑰痤疮277例甲状腺功能分析

目的分析玫瑰痤疮患者甲状腺功能(以下简称甲功)的临床特征,探讨玫瑰痤疮患者的甲功特点。方法收集2019年7月至2022年7月在新疆维吾尔自治区人民医院门诊及住院的玫瑰痤疮患者277例(病例组)及同期在该院体检中心体检的健康人群280例(对照组)作为研究对象。2组性别、年龄比较差异无统计学意义(P>0.05),具有可比性。收集2组所有研究对象的一般资料和甲功相关指标水平等数据,并对相关因素进行统计分析。结果①2组患者甲功中血清游离三碘甲状腺原氨酸(FT3)、三碘甲状腺原氨酸(T3)、促甲状腺激素(TSH)水平比较差异均有统计学意义(P<0.05),而游离甲状腺素(FT4)、甲状腺素(T4)、抗甲状腺过氧化物酶(TPO)和抗甲状腺球蛋白(TGAb)抗体水平比较差异均无统计学意义(P>0.05);②对不同病情严重程度的玫瑰痤疮患者的甲功指标进行比较,结果提示轻、中、重度玫瑰痤疮患者各项甲功指标比较差异无统计学意义(P>0.05);③2组患者甲状腺超声甲状腺大小比较差异无统计学意义(P>0.05),轻、中、重度玫瑰痤疮患者甲状腺大小比较差异也无统计学意义(P>0.05)。结论玫瑰痤疮患者的血清甲功指标水平均在正常范围,FT3、T3、TSH水平与健康人群比较差异有统计学意义(P<0.05)。

伴系统性自身抗体阳性的视神经脊髓炎谱系疾病临床特点分析

目的对比分析伴或不伴系统性自身抗体阳性的视神经脊髓炎谱系疾病(NMOSD)患者的临床特点。方法回顾性收集2019-06—2021-06于郑州大学第一附属医院住院诊治的NMOSD患者资料,按是否伴其他非特异性自身抗体分为阳性组和阴性组,比较2组患者的临床特征、实验室检查结果、影像学表现等。结果共收集到265例患者的临床资料,男女比例1∶4.5,阳性组患者占61.89%(164/265)。与阴性组患者相比,阳性组女性占比更高(90.24%比68.32%,P<0.01),AQP4阳性率更高(84.15%比66.34%,P<0.01),阳性组与阴性组随访扩展残疾状态量表(EDSS)评分分别为4.0(0,6)、2.0(0,3)(P<0.01),阳性组与阴性组脊髓受累阶段数分别为7.5(5,11)、6(4,8.3)(P=0.027),阳性组脑脊液24 h鞘内合成率7.63(3.10,16.17),阴性组为3.45(0.61,11.02)(P<0.01)。结论伴系统性自身抗体阳性的NMOSD患者脊髓受累节段更长,脑脊液炎症反应更明显,随访EDSS评分更高,非特异性自身抗体的存在可能预示不良预后。

超溶血综合征患者的诊断分析和临床治疗策略——附1例报道

目的分析1例超溶血综合征(hyperhemolysis syndrome,HHS)反应的病例,探讨该疾病的实验室检查方案和临床治疗策略。方法对患者做血型鉴定、直抗、抗筛、抗体鉴定等血清学试验,监测患者血常规,以及乳酸脱氢酶(lactate dehydrogenase,LDH)、胆红素等溶血指标,监测患者溶血的变化和发展情况。通过基因分型的方法对临床常见的32个稀有血型抗原进行检测,辅助分析抗体鉴定结果的准确性。结果患者血清中存在抗-E并合并有自身抗体,输血后LDH、胆红素明显升高,血红蛋白(Hb)急剧下降,远远低于输血前的,出现血红蛋白尿等独特表现,经过大剂量静注免疫球蛋白和皮质类固醇类激素治疗,完全康复。结论HHS是比较少见潜在致命性疾病,主要表现为溶血,严重贫血,且输血后血红蛋白水平往往低于输血前。本名患者具有输血后超溶血综合反应的典型临床表现,经过及时正确的治疗患者完全康复出院,为该类疾病的诊断和治疗积累了很好的临床经验。

肝、肾功能及免疫相关指标在视神经脊髓炎谱系疾病诊断中的应用价值

目的分析肝功能、肾功能、自身抗体指标在神经脊髓炎谱系疾病(NMOSD)患者中的分布特点及其诊断价值。方法回顾性收集2015年6月至2023年6月在首都医科大学附属北京天坛医院确诊为NMOSD、多发性硬化(MS)患者,以及性别、年龄匹配的常规体检健康者肝功能、肾功能和自身抗体检测数据。共纳入95例NMOSD患者(NMOSD组)、230例MS患者(MS组)、244例常规体检健康者(常规体检组),评估各指标对NMOSD的诊断价值。结果与MS组相比,NMOSD组丙氨酸氨基转移酶、α-羟基丁酸脱氢酶、γ-谷氨酰基转移酶水平,以及抗SS-A抗体、抗SS-B抗体、抗核糖体P蛋白抗体和Ro-52抗体阳性率等明显升高,白蛋白、间接胆红素、总胆红素水平明显降低,差异均有统计学意义(P<0.05)。NMOSD组与常规体检组差异指标与MS组相似。α-羟丁酸脱氢酶、白蛋白、球蛋白、直接胆红素、间接胆红素、总胆汁酸和尿酸碱度7项指标均可用于NMOSD诊断,联合诊断的曲线下面积为0.969,灵敏度和特异度为92.6%和92.9%。结论NMOSD患者多种肝、肾功能指标与MS和常规体检健康者存在差异,NMOSD患者部分自身抗体指标阳性率高于MS患者,临床可将肝、肾功能及自身抗体指标用于辅助诊断,并且多指标联合应用可进一步提升其诊断价值。

血清MMP1和P53自身抗体联合检测对食管鳞状细胞癌的诊断价值

目的:探讨食管鳞状细胞癌(ESCC)患者血清基质金属蛋白酶1(MMP1)和P53自身抗体表达水平及其联合检测的诊断意义。方法:收集2013年3—9月在汕头大学医学院附属肿瘤医院住院治疗的93例ESCC患者,并以同期90例体检者为正常对照组。应用酶联免疫吸附实验(ELISA)检测两组对象血清MMP1和P53自身抗体的表达水平,采用受试者工作特征(ROC)曲线评价诊断效能。结果:血清MMP1含量和P53自身抗体滴度在ESCC组分别为(8.076±5.912)ng/mL和0.291±0.492,正常对照组分别为(4.652±3.346)ng/mL和0.055±0.037,ESCC组均较正常对照组显著升高(均为P<0.01)。ROC曲线分析显示,MMP1诊断ESCC的曲线下面积(AUC)为0.700(95%CI为0.624~0.776),当取最佳诊断截断值7.248 ng/mL时,特异度为83.3%,敏感度为52.7%。P53自身抗体诊断ESCC的AUC为0.713(95%CI为0.638~0.788),诊断截断值为0.080,特异度为83.3%,敏感度为49.5%。两者联合检测诊断ESCC的AUC为0.787(95%CI为0.720~0.854),特异度为83.3%,敏感度为66.7%,优于单独使用MMP1或P53自身抗体。在早期ESCC中,MMP1和P53自身抗体联合检测亦能获得较好的诊断效能,AUC为0.760,95%CI为0.663~0.857,特异度为83.3%,敏感度为66.7%。结论:ESCC患者血清MMP1和P53自身抗体水平均升高,二者联合检测有助于ESCC的早期诊断,可作为ESCC的诊断标志物。

血小板自身抗体在血小板输注无效中的临床意义

目的观察血小板自身抗体与同种抗体对血小板交叉配型难易程度及输注效果的影响。方法选择2021年7月—2023年9月在本实验室完成血小板抗体鉴定的106例血小板输注无效(PTR)患者,根据血小板抗体类型将患者分为两组,20例自身抗体阳性患者为观察组,86例同种抗体阳性患者为对照组。比较两组患者配型相合次数百分率、配型相合供者百分率、输注交叉配型相合血小板及随机血小板的24 h血小板计数增加指数(CCI)值及输注有效率的差异,并对观察组自身抗体变化情况进行追踪。结果观察组的配型相合次数百分率及配型相合供者百分率均高于对照组(P<0.05)。观察组患者输注交叉配型相合血小板与随机血小板的24 h CCI值及输注有效率均无显著性差异(P>0.05),对照组患者输注交叉配型相合血小板的24 h CCI值及输注有效率均高于输注随机血小板(P<0.001),对照组患者输注交叉配型相合血小板后24 h CCI值及输注有效率比观察组高(P<0.05),对照组和观察组输注随机血小板后24 h CCI值及输注有效率无显著性差异(P>0.05)。观察组多数患者的自身抗体强度呈下降趋势。结论血小板自身抗体对血小板交叉配型难易程度及输注效果的影响比同种抗体小。血小板自身抗体强度随时间推移呈现逐渐下降乃至消失的规律。在临床实践中,对于自身抗体患者的治疗,应当首先查找病因,并进行针对性治疗,如果需要输注血小板,可以选择输注随机血小板。

妊娠早、中期妇女尿碘/尿肌酐比值与亚临床甲状腺功能减退症合并自身抗体阳性的相关性

目的:探讨妊娠早、中期妇女尿碘/尿肌酐比值(UIC/UCr)与亚临床甲状腺功能减退症(SCH)合并自身抗体阳性的相关性。方法:回顾性选取2018年1月—2021年6月贵阳市第一人民医院进行孕检的妊娠早、中期SCH孕妇作为研究对象,依据甲状腺自身抗体检测结果,将其分为:妊娠早、中期甲状腺抗体阳性组;妊娠早、中期甲状腺抗体阴性组;另选取同时期进行检查的妊娠早、中期健康孕妇作为对照组,每组各100例,共计300例,观察甲状腺过氧化物酶抗体(TPOAb)、甲状腺球蛋白抗体(TgAb)、UIC/UCr、促甲状腺激素(TSH)、游离三碘甲状腺原氨酸(FT3)、血清游离甲状腺素(FT4)等指标。结果:妊娠早期三组孕妇一般临床资料比较,差异无统计学意义(P>0.05),妊娠中期三组孕妇收缩压(SBP)、舒张压(DBP)比较,差异有统计学意义(F=7.024、11.357,P<0.05);UIC/UCr分析显示,与其他组别比较,妊娠早、中期阳性组孕妇均值和百分位分布数值最低;甲状腺激素及抗体水平比较,除FT3和FT4外,妊娠早、中期阳性组孕妇UIC/UCr、TPOAb、TgAb和TSH水平与健康组和阴性组比较,差异有统计学意义(F=71.710、279.102、130.017、275.949、22.991、220.702、288.882、184.459,P<0.001);相关性分析结果显示,UIC/UCr与TSH、TgAb、TPOAb水平呈负相关;多元线性回归分析结果发现,UIC/UCr、TSH是TPOAb、TgAb的主要影响因素。结论:妊娠早、中期SCH合并自身抗体阳性孕妇,UIC/UCr显著偏低且与TPOAb、TgAb关系密切,建议在临床中加强UIC/UCr指标观察。

血清NY-ESO-1自身抗体和MMP1联合检测对食管鳞状细胞癌的诊断价值

目的:探讨血清基质金属蛋白酶-1(matrix metalloproteinase-1,MMP1)和纽约食管鳞状细胞癌抗原-1(New York esophageal squamous cell carcinoma 1,NY-ESO-1)自身抗体联合检测在食管鳞状细胞癌中的诊断意义。方法:应用酶联免疫吸附实验检测120例食管鳞状细胞癌患者和120例正常对照血清中MMP1和NY-ESO-1自身抗体的表达水平,采用受试者工作特征(receiver operating characteristic,ROC)曲线评价诊断效能。结果:血清MMP1和NY-ESO-1自身抗体在食管鳞状细胞癌患者中的表达均明显高于正常对照[(8.070±5.738)ng/mL vs(4.331±3.137)ng/mL,Z=6.214,P<0.001;0.463±0.571 vs 0.156±0.086,Z=5.210,P<0.001]。ROC曲线显示,当血清MMP1为最佳诊断临界值10.586 ng/mL时,其在诊断食管鳞状细胞癌的曲线下面积(area under the ROC curve,AUC)为0.732(95%CI:0.671~0.787),敏感度为24.2%,特异度为95.0%。NY-ESO-1自身抗体诊断食管鳞状细胞癌AUC为0.695(95%CI:0.632~0.752),敏感度为33.0%,特异度为95.0%。MMP1和NY-ESO-1自身抗体联合检测诊断食管鳞状细胞癌的AUC为0.800(95%CI:0.744~0.849),敏感度为47.5%,特异度为95.0%。结论:血清MMP1和NY-ESO-1自身抗体联合检测可能有助于提高食管鳞状细胞癌的诊断效能。

和阳消瘿汤联合优甲乐治疗脾气亏虚型桥本甲状腺炎疗效及对甲状腺激素、甲状腺自身抗体水平的影响

目的:观察和阳消瘿汤联合优甲乐治疗脾气亏虚型桥本甲状腺炎的疗效及对甲状腺激素、甲状腺自身抗体水平的影响。方法:选取2020年5月~2022年5月期间于我院接受治疗的脾气亏虚型桥本甲状腺炎患者114例为研究对象,按照随机数字表法分为观察组与对照组,其中57例对照组患者给予优甲乐治疗,57例观察组患者在以上对照组基础上给予和阳消瘿汤。比较两组治疗前后甲状腺激素[游离三碘甲状腺原氨酸(FT_(3))、游离甲状腺素(FT_(4))、促甲状腺激素(TSH)]、甲状腺自身抗体水平[抗甲状腺球蛋白抗体(TG-Ab)、甲状腺过氧化物酶抗体(TPO-Ab)]及中医证候积分的变化,并对其疗效及安全性进行客观评价。结果:治疗前两组各项指标比较无明显差异(P>0.05),治疗后TG-Ab、TPO-Ab、TSH及中医证候积分均降低(P<0.05),FT_(3)、FT_(4)均升高(P<0.05),且治疗后观察组TG-Ab、TPO-Ab、TSH、中医证候积分低于对照组(P<0.05),FT_(3)、FT_(4)高于对照组,差异有统计学意义(P<0.05);观察组总有效率为91.23%,明显高于对照组的71.93%(P<0.05),但两组不良事件发生率相比差异无统计学意义(P>0.05)。结论:和阳消瘿汤联合优甲乐治疗脾气亏虚型桥本甲状腺炎,与单纯优甲乐治疗相比,在调节甲状腺激素、降低自身抗体水平、纠正临床症状上优势明显,且疗效及安全性可靠。

甲功五项与TPOAb、TGAb联合诊断甲状腺功能减退的临床价值

目的探究甲功五项联合甲状腺过氧化物酶自身抗体(TPOAb)及抗甲状腺球蛋白抗体(TGAb)诊断甲状腺功能减退(简称甲减)的临床价值。方法将2022年10月至2023年10月在甘肃省天水市第一人民医院进行检查的108例甲减患者纳入研究组,于同期随机挑选108例健康体检人员作为对照组。两组均进行甲功五项、TPOAb、TGAb检测,分析甲功五项与TPOAb、TGAb联合检验诊断甲减的临床效能。结果与对照组比,研究组血清三碘甲状腺原氨酸(T_(3))、四碘甲腺原氨酸(T_(4))、游离三碘甲状腺原氨酸(FT_(3))、游离四碘甲腺原氨酸(FT_(4))水平更低,促甲状腺激素(TSH)、TPOAb、TGAb水平更高,P<0.05;甲功五项与TPOAb、TGAb联合检验诊断甲减的灵敏度、特异度、准确率均高于单一指标检验,P<0.05。结论甲功五项与TPOAb、TGAb联合检验可提高甲减诊断准确率,为后续治疗提供参考。

肺癌七项自身抗体联合检测在肺结节良恶性鉴别诊断中的应用价值

目的探讨肺癌七项自身抗体检测在肺结节良恶性鉴别诊断中的临床价值。方法选取肺癌患者45例作为观察组,另选同期收治的良性肺结节患者45例作为对照组,所有患者均采集血液进行抑癌基因53(p53)、干细胞转录因子2(SOX2)、肿瘤睾丸抗原7(GAGE7)、蛋白基因产物9.5(PGP9.5)、人癌抗原(Cage)、黑色素瘤抗原A1(MAGEA1)、肿瘤抗原4-5(Gbu4-5)检测,比较2组各抗体间差异;并依据肺癌肿瘤分期分为Ⅰ~Ⅱ、Ⅲ~Ⅳ期患者,比较2组各抗体间水平差异;绘制ROC曲线,分析各抗体及联合检测鉴别诊断良恶性肺结节的临床价值。结果观察组p53、SOX2、GAGE7、PGP9.5、Cage、MAGEA1、Gbu4-5水平高于对照组,差异有统计学意义(P<0.05)。45例肺癌患者中Ⅰ~Ⅱ期29例,Ⅲ~Ⅳ期16例;Ⅲ~Ⅳ期患者p53、SOX2、GAGE7、PGP9.5、Cage、MAGEA1、Gbu4-5水平高于Ⅰ~Ⅱ期患者,差异有统计学意义(P<0.05)。绘制ROC曲线显示,联合肺癌七项自身抗体检测鉴别诊断肺结节良恶性价值更高。结论肺癌七项自身抗体检测在肺结节良恶性鉴别诊断中价值高,可提高诊断灵敏度及特异度,有助于后续针对性治疗工作的开展。