摘要
目的探讨自身免疫性疾病(AID)患者血清抗核抗体(ANA)和抗核抗体谱(ANAs)的表达及临床意义。方法选取2013年1月至2015年4月海南省第三人民医院收治的194例AID患者和103例非AID患者(对照组),根据美国风湿病学会的诊断标准将194例AID患者分为系统性红斑狼疮(SLE)组、混合性结缔组织病(MCTD)组、干燥综合征(SS)组、硬皮病(PSS)组、类风湿性关节炎(RA)组和过敏性紫癜(AP)组。采用间接免疫荧光法(IIF)和免疫印迹法(IBT)检测所有患者的ANA和ANAs,并进行统计分析。结果女性患者检出ANA、Ul-Sn RNP、抗ds DNA、抗SSA、抗SSB、抗核小体和抗组蛋白的阳性率均明显高于男性,差异均有统计学意义(P<0.05);在不同AID患者中ANA检测均呈阳性,其中SLE组阳性率最高,达93.5%,其次分别为MCTD组(85.0%)、SS组(79.2%)、PSS组(69.2%)、RA组(35.8%)、AP组(20.0%),均明显高于对照组(4.9%),差异均有统计学意义(P<0.05)。RA组主要表达抗组蛋白(47.7%),明显高于对照组(1.0%)。SLE组主要表达抗Sm Dl(37.9%)、抗ds DNA(66.1%)、抗SSA(41.9%)、抗核小体(77.4%)和抗组蛋白(37.1%),均明显高于对照组,差异均有统计学意义(P<0.05)。SS组主要表达抗SSA(58.3%)和抗SSB(50.0%),均明显高于对照组。MCTD组主要表达Ul-Sn RNP(35.0%)、抗SSA(60.0%)和抗SSB(30.0%),均明显高于对照组。PSS组和AP组主要表达抗Scl-70(46.1%和10.0%),均明显高于对照组,差异均有统计学意义(P<0.05);130例ANA阳性患者检出97例ANAs阳性,符合率74.6%;64例ANA阴性患者检出58例ANAs阴性,符合率为90.6%;AID患者ANA核型分布以核颗粒型和核均质型为主,其他核型较少见;核颗粒型多为抗SSA(48.5%)、抗SSB(23.7%)和抗组蛋白(26.8%),核均质型多为抗ds DNA(28.9%)、抗核小体(29.9%)和抗组蛋白(25.7%)。结论 ANA可辅助诊断自身免疫性疾病,但缺乏特异性,联合抗核抗体谱检测对AID的诊断有重要意义。
Objective To investigate the expression and clinical significance of serum antinuclear antibody(ANA) and antinuclear antibody spectrum(ANAs) in patients with autoimmune diseases(AID). Methods A total of194 cases of AID patients and 103 cases of patients without AID(control group) in the Third People's Hospital of Hain-an Province were selected from January 2013 to April 2015. According to the diagnostic criteria of the American College of Rheumatology, the 194 patients with AID were divided into 6 groups as systemic lupus erythematosus(SLE)group, mixed connective tissue diseases(MCTD) group, sicca syndrome(SS) group, progressive systemic sclerosis(PSS) group, rheumatoid arthritis(RA) group and allergic purpura(AP) group. ANA and ANAs of all patients were detected by indirect immunofluorescence(IIF) and immunoblotting test(IBT), and the statistical analysis was performed. Results The positive rates of ANA, Ul-Sn RNP, anti ds DNA, anti SSA, anti SSB, anti nuclear and anti histone in female patients were significantly higher than those in males, and the differences were statistically significant(P<0.05). ANA test was positive in different AID patients, among which the positive rate of SLE group was the highest(93.5%), followed by MCTD group(85.0%), SS group(79.2%), PSS group(69.2%), RA group(35.8%), AP group(20.0%), which were significantly higher than those of control group(4.9%). The expression of anti histone(47.7%) in the RA group was significantly higher than that in the control group(1.0%). SLE group mainly expressed anti-Sm Dl(37.9%), anti-ds DNA(66.1%), anti-SSA(41.9%), anti-nucleosome(77.4%) and anti-histone(37.1%), which were significantly higher than those of the control group(P<0.05). SS group mainly expressed anti-SSA(58.3%) and anti-SSB(50.0%), which were significantly higher than those of the control group(P<0.05). MCTD group mainly expressed Ul-Sn RNP(5.0%), anti SSA(60.0%) and anti SSB(30.0%), which were significantly higher than those of the control group(P<0.05). PSS and AP group mainly expressed
出处
《海南医学》
CAS
2016年第18期2965-2968,共4页
Hainan Medical Journal
关键词
自身免疫性疾病
抗核抗体
抗核抗体谱
表达
临床意义
Autoimmune diseases(AID)
Antinuclear antibody(ANA)
Antinuclear antibody spectrum(ANAs)
Expression
Clinical significance
