抗核抗体及特异性自身抗体检测结果的应用分析  

Application analysis of determination results of anti-nuclear antibody and specific autoantibodies

作　　者：邱蕴文[1] 吴俊渊[2] 

机构地区：[1]江苏省南通市第一人民医院检验科,226001 [2]南通大学附属第二医院检验科,江苏南通226001

出　　处：《检验医学与临床》2016年第6期763-764,767,共3页Laboratory Medicine and Clinic

摘　　要：目的探讨间接免疫荧光法(IIF)检测抗核抗体(ANA)及线性免疫印迹法(LIA)检测特异性自身抗体在自身免疫性疾病(AID)诊断中的应用价值。方法 1 386例患者标本同时采用IIF法检测ANA和用LIA法检测特异性自身抗体,结合临床诊断将患者分为AID组和非AID组,将两种方法检测结果进行比较分析。结果 IIF和LIA诊断AID的灵敏度分别为83.02%和60.38%,特异度分别为65.87%和84.13%,两者联合检测诊断AID的灵敏度和特异度分别为83.73%和94.58%,阴性预期值为85.22%;在222例IIF与LIA结果不一致的AID患者中,有129例诊断为类风湿性关节炎(RA),其中结果为IIF(+)LIA(-)的,诊断为RA的114例,占62.30%;结果为IIF(-)LIA(+)的,诊断为RA的15例,占38.46%,其次诊断为多发性肌炎/皮肌炎(PM/DM)的占30.77%,没有诊断为系统性红斑狼疮的病例。结论 IIF和LIA联合检测,可提高AID诊断的特异性和准确性,且对排除AID诊断是有一定意义的。当两种检测结果不一致时,应根据患者临床症状,作进一步相关检查,以便明确诊断。Objective To explore the application value of the indirect immunofluorescence（IIF）method for detecting anti-nuclear antibody（ANA）and the linear immunoblotting（LIA）method for detecting specific autoantibodies in the diagnosis of autoimmune disease（AID）.Methods Totally 1 386 of samples from the patients were simultaneously detected ANA by IIF and the specific autoantibodies by LIA.These patients were divided into the AID group and the non-AID group by combining with the clinical diagnosis.The results detected by the two kinds of method were performed the comparative analysis.Results The sensitivities of IIF and LIA in the diagnosis of AID were83.02% and 60.38%,their specificities were 65.87% and 84.13% respectively,while the sensitivity and specificity of combined detection in the diagnosis of AID were 83.73%and 94.58%,the negative predictive value was 85.22%.In 222 patients with inconsistent IIF and LIA results,129 cases were diagnosed as rheumatoid arthritis（RA）,in which,114 cases were IIF（＋）LIA（-）and accounted for 62.30%;15cases were IIF（-）LIA（＋）and accounted for 38.46%;followed by a diagnosis of polymyositis/dermatomyositis（PM/DM）,which accounted for 30.77%,there was no diagnosis of systemic lupus erythematosus（SLE）.Conclusion The combined detection of IIF and LIA can improve the specificity and accuracy of AID diagnosis,and has certain significance to rule out the diagnosis of AID.When the two detection results are inconsistent,the further related detection should be conducted according to clinical symptoms for clarifying the diagnosis.

关 键 词：抗核抗体 特异性自身抗体 间接免疫荧光法 线性免疫印迹法 自身免疫性疾病 

分 类 号：R685.2[医药卫生—骨科学]