摘要
目的分析组织病理、DIF、IIF和ELISA四种实验室检测方法在天疱疮患者诊断中的临床意义。方法回顾性分析273例天疱疮住院患者的组织病理、DIF、IIF、抗Dsg1和抗Dsg3抗体的检查结果。结果组织病理检查显示,186例(82.30%,186/226)表现为表皮内水疱形成或细胞松解;DIF检查显示,170例(80.19%,170/212)结果阳性,其中7例仅出现皮肤基底膜带C3线状沉积,伴有/不伴有IgG线状沉积;IIF检查显示,77例(69.37%,77/111)检查结果呈现阳性;抗Dsg1和抗Dsg3抗体检测显示,126例(95.45%,126/132)出现抗Dsg1抗体和/或抗Dsg3抗体阳性。寻常型及增殖型天疱疮抗Dsg3抗体阳性率(89.53%)明显高于红斑型及落叶型(25.64%),差异有统计学意义(P=0.000);伴有/仅有黏膜损害的天疱疮患者抗Dsg3抗体阳性率(89.04%)亦显著高于仅有皮肤损害的天疱疮患者(38.18%),差异有统计学意义(P=0.000)。结论在天疱疮四种实验室诊断方法中,抗Dsg1和抗Dsg3抗体检测的阳性率最高。四种检查方法联合应用有助于天疱疮的正确诊断。
Objective To analyze the clinical significance of four laboratory methods including histopathology,direct immunofluorescence(DIF),indirect immunofluorescence(IIF)and enzyme-linked immuno-sorbent assay(ELISA)in the diagnosis of patients with pemphigus.Methods We retrospectively analyze the findings of histopathology,DIF,IIF and ELISA in 273 cases of patients with pemphigus.Results The histopathological examination revealed that acantholysis or formation of blister in the epidermis was present in 186 cases(82.30%,186/226).DIF examination showed positive results in 170 cases(80.19%,170/212)of patients.Only deposition of C3 along the basement membrane zone with/without IgG was observed in 7 of 170 cases.IIF examination showed that 77 cases(69.37%,77/111)of patients had circulating antibodies directing against intercellular components of epidermis or mucosal epithelium.ELISA showed positive anti-Dsg1 and/or anti-Dsg3 antibodies in 126 cases(95.45%,126/132)cases.The positive rate of anti-Dsg3 antibodies in pemphigus vulgaris and pemphigus vegetans was significantly higher than that in pemphigus erythematosus and pemphigus foliaceus(89.53%vs.25.64%)(P=0.000).The positive rate of anti-Dsg3 antibodies in pemphigus associated with/only with the involvement of mucosa was higher than that in pemphigus with only involvement of skin(89.04%vs.38.18%)(P=0.000).Conclusion The positive rate of anti-desmoglein 1 and 3 antibodies by ELISA is highest in four laboratory methods for diagnosing pemphigus.The combined utilization of these four methods can help us make an accurate diagnosis of pemphigus.
作者
李秀秀
吴楠
杜文辉
张书梅
王培光
LI Xiuxiu;WU Nan;DU Wenhui;ZHANG Shumei;WANG Peiguang(Department of Dermatology and Venerology,the First Affiliated Hospital of Anhui Medical University,Hefei 230022,China)
出处
《中国皮肤性病学杂志》
CAS
CSCD
北大核心
2021年第1期110-115,共6页
The Chinese Journal of Dermatovenereology
