2种检测系统测定抗核抗体谱的一致性分析  

Consistency of 2 systems for the determination of antinuclear antibody profile

作　　者：詹文丽[1] 李立新[1] 黄卓春[1] 胡静[1] 武永康[1] 

机构地区：[1]四川大学华西医院实验医学科,四川成都610041

出　　处：《检验医学》2016年第11期969-973,共5页Laboratory Medicine

摘　　要：目的比较临床常用的2种抗核抗体(ANA)谱检测系统检测结果的一致性,为临床选择ANA谱检测方法提供依据。方法收集358例系统性红斑狼疮(SLE)患者、147例其他自身免疫性疾病患者及47名健康体检者血清,分别使用胡曼(德国)诊断有限公司(简称胡曼)和欧蒙(中国)医学诊断有限公司(简称欧蒙)免疫印迹法检测系统检测ANA谱,通过计算符合率和Mc Nemar检验对2种试剂的检测结果进行一致性分析。结果 2种检测系统检测抗史密斯(Sm)抗体、抗核糖体蛋白(RIB)抗体和抗核糖核蛋白(RNP)抗体的符合率分别为79.9%、93.5%和82.4%,差异有统计学意义(P<0.001),而ANA谱其余4项[抗干燥综合征A(SS-A)抗体,抗干燥综合征B(SS-B)抗体,抗硬皮病70蛋白(Scl-70)抗体和抗Jo-1抗体]符合率均>90%,差异无统计学意义(P>0.05)。在358例SLE患者中,胡曼检测系统抗Sm抗体的检出率为48.6%,欧蒙检测系统的检出率为27.1%;在194例非SLE患者中,胡曼检测系统检测抗Sm抗体的特异性为93.3%,欧蒙检测系统为99.5%。结论胡曼和欧蒙检测系统检测ANA谱时抗Sm抗体、抗RIB抗体和抗RNP抗体一致性较差,其余4项指标一致性较好。在SLE患者中,胡曼检测系统的抗Sm抗体检出率优于欧蒙检测系统,但特异性低于欧蒙检测系统。Objective To evaluate the consistency of commonly-used 2 systems for the determination of antinuclear antibody（ANA） profile,and to provide a reference for choosing methods for ANA profile determination. Methods Sera from 358 patients with systemic lupus erythematosus（SLE）,147 patients with autoimmune disease and 47 healthy subjects were collected,and were determined for ANA profile by 2 systems, HUMAN（Germany） Diagnostics Ltd. and EUROIMMUN（China） Medical Diagnosis Ltd.. The calculated consistency and McNemar test were used to evaluate the consistency of 2 systems. Results The consistencies of anti-Smith（Sm） antibody,anti-ribosomal protein（RIB） antibody and anti-ribonucleoprotein（RNP） antibody were 79.9%,93.5%and 82.4%,with statistical significance（P〈0.001）. The consistencies of other 4 indices[anti-Sjogren syndrome A（SS-A） antibody,anti-Sjogren syndrome B（SS-B）antibody,anti-scleroderma 70（Scl-70） antibody and anti-Jo-1 antibody] were〉90%,without statistical significance（P〉0.05）. Among 358 SLE patients, the positive rates of anti-Sm antibody were 48.6%by HUMAN and 27.1%by EUROIMMUN. Among 194 non-SLE patients,the specificities of anti-Sm antibody were 93.3%by HUMAN and 99.5%by EUROIMMUN. Conclusions The consistencies of HUMAN and EUROIMMUN in determining anti-Sm,anti-RIB and anti-RNP antibodies are low,while the other 4 indices show good consistencies. For the determination of anti-Sm antibody,HUMAN reveals a better determination rate and lower specificity than EUROIMMUN.

关 键 词：抗核抗体 免疫印迹法 比对 一致性 

分 类 号：R446.1[医药卫生—诊断学]