抗麦胶蛋白抗体和抗肌内膜抗体在麸质敏感性肠病诊断中的应用  

The application of anti-gliadin antibody and anti-endomysial antibody immunoglobulin A,immunoglobulin G levels detection in diagnosis of gluten sensitive enterpathy

作　　者：易浔飞[1] 张静兰[1] 刘飞[1] 江裕[2] 

机构地区：[1]南京军区福州总医院全军临床检验医学研究所,福州市350025 [2]福州市第二医院检验科,福州市350007

出　　处：《实用检验医师杂志》2015年第1期21-24,共4页Chinese Journal of Clinical Pathologist

摘　　要：目的评价抗麦胶蛋白抗体和抗肌内膜抗体Ig G、Ig A检测在诊断麸质敏感性肠病(gluten sensitive enterpathy,GSE)中的应用价值。方法选择2012年8月至2014年9月我院门诊及住院的GSE患者35例作为GSE组;同时期健康体检者50例作为健康对照组。采用ELISA法和间接免疫荧光法检测所有受试者的抗麦胶蛋白抗体和抗肌内膜抗体,并对实验数据进行统计学分析。结果 GSE组中抗麦胶蛋白抗体Ig G、抗麦胶蛋白抗体Ig A、抗肌内膜抗体Ig G和抗肌内膜抗体Ig A的阳性率分别为25.7%(9/35)、25.7%(9/35)、14.3%(5/35)和28.6%(10/35),均显著高于健康对照组,且差异均有统计学意义(P均<0.05)。抗麦胶蛋白抗体和抗肌内膜抗体联合检测的阳性率分别为45.7%(抗麦胶蛋白抗体Ig G+抗麦胶蛋白抗体Ig A)、37.1%(抗肌内膜抗体Ig G+抗肌内膜抗体Ig A)和48.6%(抗麦胶蛋白抗体Ig G、Ig A+抗肌内膜抗体Ig G、Ig A),均显著高于健康对照组,且差异均有统计学意义(P均<0.05)。抗麦胶蛋白抗体和抗肌内膜抗体单独诊断GSE的特异性和阳性预测值较高,可达100.0%(抗肌内膜抗体Ig G、Ig A),而敏感性均较低。抗麦胶蛋白抗体和抗肌内膜抗体联合检测诊断GSE的敏感性有所提高,其中最高的为48.6%(抗麦胶蛋白抗体Ig G、Ig A+抗肌内膜抗体Ig G、Ig A)。结论抗麦胶蛋白抗体和抗肌内膜抗体联合检测可提高诊断GSE的敏感性,减少漏诊。对GSE高危人群应检测抗麦胶蛋白抗体和抗肌内膜抗体进行筛查和诊断。Objective To evaluate the clinical value of anti-gliadin antibody IgG , IgA and anti-en-domysial antibody IgG, IgA in the diagnosis of gluten sensitive enterpathy （GSE）. Methods 35 cases GSE patients （GSE group） and 50 cases healthy people （healthy control group） were selected from August 2012 to September 2014 in our hospital. The levels of anti-gliadin antibody IgG , IgA and anti-endomysial antibody IgG, IgA were measured by ELISA method and indirect immunofluorescence method, respectively. All data were analyzed statistically. Results The positive rates of anti-gliadin antibody IgG, IgA and anti-endomysial antibody IgG, IgA in GSE group were 25.7%（9/35）, 25.7%（9/35）, 14.3%（5/35） and 28.6%（10/35）, re-spectively, which were all higher than that of healthy control group. And the differences all had statistical sig-nificance（Pall〈0.05）. The positive rates of anti-gliadin antibody IgG, IgA and anti-endomysial antibody IgG, IgA combined detection were 45.7%（anti-gliadin antibody IgG, IgA）, 37.1%（anti-endomysial antibody IgG, IgA） and 48.6%（anti-gliadin antibody IgG, IgA＋anti-endomysial antibody IgG, IgA）, which were all higher than that of healthy control group. And the differences all had statistical significance （Pall〈0.05）. Anti-gliadin antibody IgG, IgA and anti-endomysial antibody IgG, IgA had high specificity and positive predictive value in the diagnosis of GSE, but had low sensitivity. The highest specificity and positive predictive value were all 100.0%（anti-endomysial antibody IgG, IgA）. The sensitivity increased in combined detection of anti-gliadin antibody IgG, IgA and anti-endomysial antibody IgG, IgA, the highest was 48.6%（anti-gliadin antibody IgG, IgA＋anti-endomysial antibody IgG, IgA）. Conclusion Anti-gliadin antibody IgG, IgA and anti-endomysial antibody IgG, IgA combined detection can improve the sensitivity in the diagnosis of GSE, and reduce misdi-agnosis. The GSE high risk group should detect anti-gliadin antibody IgG , IgA and an

关 键 词：麸质敏感性肠病 谷胶病 抗麦胶蛋白抗体 抗肌内膜抗体 免疫球蛋白 

分 类 号：R574[医药卫生—消化系统]