摘要
目的探讨类风湿关节炎(rheumatoid arthritis,RA)相关自身抗体对HIV病毒不同筛查方法的影响,为临床中出现的HIV检测结果假阳性提供解释依据。方法选择2015年7月~2016年7月我院接诊的90例RA患者进行检测,按RA抗体类风湿因子(rheumatoid factor,RF)值高低分为RF<18 U/m L组(n=33)和RF>300 U/m L(n=57);按抗环瓜氨酸肽抗体(抗CCP抗体)值高低分为抗CCP抗体浓度<25 RU/m L组(n=39)和抗CCP抗体浓度>500 RU/m L组(n=51),采用快速胶体金法、酶联免疫吸附法(ELISA)及电化学发光法(ECLIA)对所有患者进行血清HIV病毒检测,阳性标本采用免疫印记确认实验,并采用ELISA法对所有患者RF及抗CCP抗体进行检测。结果快速胶体金法和ELISA法所检测的所有患者结果均为阴性,ECLIA法检测出12例患者HIV抗体呈阳性,阳性标本采用免疫印记确认,结果均为阴性,差异有统计学意义(P<0.05);ECLIA法检测RF-Ig M<18 U/m L组的HIV抗体呈阳性患者1例,RF-Ig M>300 U/m L及RF-Ig G>300 U/m L的HIV抗体呈阳性患者分别为11例、3例,差异有统计学意义(P<0.05);抗CCP抗体浓度<25 RU/m L组中HIV抗体呈阳性患者2例,抗CCP抗体浓度>500RU/m L组HIV抗体呈阳性患者12例,两组比较差异有统计学意义(P<0.05)。结论类风湿关节炎高滴度的自身抗体对ECLIA法检测患者HIV抗体具有一定的影响,会导致假阳性的产生,因此多种检测方式进行筛查是有必要的。
Objective To investigate the influence of autoantibodies associated with rheumatoid arthritis（RA）on differ- ent HIV screening methods and to provide an explanation basis for the false positive of HIV test results in clinic. Methods 90 RA patients admitted in our hospital from July 2015 to July 2016 were enrolled in the study. According to the rheumatoid factor（RF） value of RA antibody, the patients were divided into RF〈18 U/mL group（n=33） and RF〉 300 U/mL group（n=57）. According to anti-cyclic citrullinated peptide（anti-CCP） value, the patients were divided into anti-CCP antibody concentration 〈25 RU/mL group（n=39）and anti-CCP antibody concentration〉500 RU/mL group（n= 51）. Serum HIV was detected in all patients by rapid colloidal gold assay, enzyme-linked immunosorbent assay（ELISA） and electrochemiluminescence （ECLIA）. The positive samples were confirmed by immunoblot. The RF and anti-CCP antibodies in all patients were detected by ELISA method. Results All the patients tested by rapid colloidal gold assay and ELISA showed negative results. HIV antibodies in 12 patients were positive detected by ECLIA method and posi- tive samples were confirmed by immunoblot. The results were negative（P〈0.05）. There was 1 patient with HIV antibody- positive detected by ECLIA test in RF-IgM 〈18 U/mL group. There were 11 and 3 HIV antibody-positive patients in RF-IgM〉300 U/mL and RF-IgG〉300 U/mL group, respectively, and the difference between the two groups was signifi- cant（P〈0.05）. There were 2 and 12 cases of HIV antibody positive in the anti-CCP antibody concentration 〈25 RU/mL group and anti-CCP antibody concentration〉500 RU/mL HIV group, and the difference between the two groups was statistically significant（P〈0.05）. Conclusion The high titer of autoantibodies to rheumatoid arthritis may affect the de- tection of HIV antibodies by ECLIA and lead to false positives. Therefore, a variety of testing methods for screening are necessary.
出处
《中国现代医生》
2018年第6期124-127,共4页
China Modern Doctor
基金
浙江省医药卫生科技计划项目(2014KYB318)
