不明原因眼眶疾病患者血清IgG4及自身抗体检测分析  

Detection of IgG4 and autoantibodies in patients with orbital disease of unknown origin

作　　者：何小魁[1] 刘向祎[1] 岳燕[1] 白婕[1] 张晓红[1] He Xiaokui Liu Xiangyi Yue Yan Bai Jie Zhang Xiaohong(Department of Laboratory Medicine, Beijing Tongren Hospital Affiliated to Capital Medical University, Beijing 100730, China)

机构地区：[1]首都医科大学附属北京同仁医院检验科,100730

出　　处：《中华检验医学杂志》2017年第5期387-390,共4页Chinese Journal of Laboratory Medicine

基　　金：北京市首都特色基金（z141107006614007）

摘　　要：目的探讨以不明原因眼眶病变为主要表现的患者血清免疫球蛋白G4（IgG4）水平及自身抗体成分,分析血清IgG4及自身抗体检测在眼眶疾病患者的应用价值.方法回顾性选择2013年10月至2016年10月就诊于北京同仁医院眼科、以不明原因眼眶病变为主要表现的患者366例作为眼眶疾病组,同时以同期就诊于该院风湿免疫科以自身免疫性疾病为主要表现的患者266例作为对照组,采用散射比浊法检测各组血清IgG4含量,采用间接免疫荧光法检测各组血清抗核抗体（ANA）、抗双链DNA（dsDNA）抗体,采用线性免疫印迹法检测各组血清抗可提取性核抗原（ENA）抗体,采用酶联免疫吸附法检测各组血清抗中性粒细胞胞浆抗体（ANCA）,分别采用卡方检验进行对比分析.结果眼眶疾病组血清IgG4阳性检出率为36.1％（132/366）,高于对照组的27.1％（72/266）,差异有统计学意义（χ^2=5.705,P=0.017）.且眼眶疾病组血清IgG4≥1350mg/L的阳性检出率为29.0％（106/366）,也高于对照组的21.8％（58/266）,差异有统计学意义（χ^2=4.107,P=0.043）.在自身抗体检测方面,眼眶疾病组ANA阳性检出率为17.8％（65/366）,低于对照组的28.6％（76/266）,差异有统计学意义（χ^2=10.389,P=0.001）;抗ENA抗体阳性检出率为4.6％（17/366）,低于对照组的9.0％（24/266）,差异有统计学意义（χ^2=4.866,P=0.027）;眼眶疾病组所有病例均未检测出抗dsDNA抗体;眼眶疾病组仅3例患者血清ANCA阳性,阳性检出率为0.8％（3/366）,与对照组的3.0％（8/266）相比,差异无统计学意义（χ^2=3.127,P=0.077）.结论眼眶疾病患者常伴有血清IgG4水平明显升高,但自身抗体检测多为阴性,提示IgG4可能与眼眶疾病有一定关联.Objective To detect the serum IgG4 and autoantibodies levels in patients with orbital disease of unknown reasons,and to investigate their values in patients with orbital disease.Methods A total of 366 patients with orbital disease of unknown reasons recruited in the Department of Ophthalmology,Beijing Tongren Hospital Affiliated to Capital Medical University from October 2013 to October 2016 were retrospectively enrolled as orbital disease group,and 266 patients with autoimmune disease in the same period from the Department of Rheumatology of the hospital were selected as controls.The serum IgG4 was detected by rate scattering method,antinuclear antibody（ANA）,anti-double-stranded DNA（dsDNA）antibody as well as anti-extractable nuclear antigen（ENA）antibody were measured by indirect immunofluorescence assay,and anti-neutrophil cytoplasmic antibody（ANCA）was detected by enzyme linked immunosorbent assay,all of which were compared between the orbital disease patients and the controls using chi-square test.Results The positive rate of the serum IgG4 in the patients with orbital disease was 36.1%（132/366）,obviously higher than that in the controls（27.1%,72/266）,the difference being statistically significant（χ^2 =5.705,P=0.017）.And the positive rate of serum IgG4≥1 350 mg/L（29.0%,106/366）in the patients with orbital disease was higher than that in the controls（21.8%,58/266; χ^2 =4.107,P=0.043）.The positive rate of ANA in the patients with orbital disease was 17.8%（65/366）,obviously lower than that in the controls（28.6%,76/266）,the difference also being statistically significant（χ^2 =10.389,P=0.001）.The positive rate of anti-ENA antibody in the patients with orbital disease was 4.6%（17/366）,also obviously lower that that in the controls（9.0%,24/266）,with statistically significant difference as well（χ^2 =4.866,P=0.027）.No anti-dsDNA antibody was detected in the patients with orbital disease.Only three patients with orbital disease（0.8%,3/366）were found AN

关 键 词：眶疾病 免疫球蛋白G 自身抗体 自身免疫疾病 病例对照研究 

分 类 号：R446.6[医药卫生—诊断学] R777.5[医药卫生—临床医学]