ANA、ANCA、HLA-B27、anti-dsDNA在诊断免疫相关性葡萄膜炎中的价值  

Study on the value of ANA,ANCA,HLA-B27 and anti-dsDNA in the diagnosis of immune-related uveitis

作　　者：王兵[1] 刘娴[1] Bing Wang;Xian Liu(Department of Ophthalmology,the First Affiliated Hospital of Nanyang Medical College,Nanyang 473000,Henan Province,China)

机构地区：[1]南阳医学高等专科学校第一附属医院眼科,中国河南省南阳市473000

出　　处：《国际眼科杂志》2018年第1期108-111,共4页International Eye Science

摘　　要：目的:探讨抗核抗体(ANA)、抗中性粒细胞胞质抗体(ANCA)、人类白细胞抗原B27(HLA-B27)、抗双链DNA抗体(anti-dsDNA)在诊断免疫相关性葡萄膜炎中的价值。方法:选取70例免疫相关性葡萄膜炎患者,收集患者的临床资料,检测患者血清中ANA、ANCA、anti-dsDNA和外周血淋巴细胞HLA-B27的表达水平。结果:男性患者年龄低于女性(t=2.845,P<0.05);70例免疫相关性葡萄膜炎患者中,脊柱关节炎、原发性系统性血管炎、系统性红斑狼疮、原发性干燥综合征、类风湿性关节炎及幼年性特发性关节炎分别有42、12、6、5、4、1例,男女之间其中脊柱关节炎和系统性红斑狼疮比例差异有统计学意义(P=0.019、0.008)。ANA阳性率为16%(11/70),ANCA阳性率为10%(7/70),HLA-B27阳性率为59%(41/70),anti-dsDNA阳性率为6%(4/70);其中,男性的ANA、ANCA、anti-dsDNA阳性率均低于女性(P<0.05),男性HLA-B27阳性率高于女性(χ2=4.427,P<0.05),差异均具有统计学意义。70例免疫相关性葡萄膜炎发病部位主要是前葡萄膜(49%)和全葡萄膜(46%)。ANA主要在系统性红斑狼疮(83%)和原发性干燥综合征(60%)中表达;ANCA在免疫相关性葡萄膜炎中均有表达(除外脊柱关节炎和幼年性特发性关节炎);HLA-B27主要在脊柱关节炎(93%)中表达;anti-dsDNA主要在系统性红斑狼疮(67%)和类风湿性关节炎(25%)中表达。结论:ANA、ANCA、HLA-B27、anti-ds DNA的阳性率在不同免疫相关性葡萄膜炎的表现类型具有差异,对于免疫相关性葡萄膜炎的分类具有一定的辅助诊断作用。AIM:To investigate the value of ANA,ANCA,HLA-B27,anti-dsDNA in the diagnosis of immune-related uveitis.METHODS:Totally70patients with immune-related uveitis were selected and the clinical data were collected.The levels of ANA,ANCA,anti-dsDNA in serum and HLA-B27in peripheral blood lymphocytes were measured.RESULTS:Male patients were younger than femle patients(t=2.845,P<0.05);there were42cases,12cases,6cases,5cases,4cases,1case,repectively in spondyloarthritis,primary systemic vasculitis,systemic lupus erythematosus,primary Sjogren’s syndrome,rheumatoid arthritis and juvenile idiopathic arthritis among the70patients with immune-related uveitis.The proportion of spondylitis and systemic lupus erythematosus between men and women had significant difference(P=0.019,0.008).The ANA positive rate was16%(11/70),the positive rate of ANCA was10%(7/70),the positive rate of HLA-B27was59%(41/70),the positive rate of anti-dsDNA was6%(4/70).Among the cases,in male ANA,ANCA,anti-dsDNA positive rate was lower than in women(P<0.05).The positive rate of HLA-B27in male was higher than that in female,the difference was significant(^=4.427,P<0.05).The main site of the disease in70cases of immune-related uveitis were the anterior uvea(49%)and the entire uvea(46%).ANA was mainly expressed in systemic lupus erythematosus(83%)and primary Sjogren’s syndrome(60%);ANCA was expressed in immune-related uveitis(except for spondyloarthritis and juvenile idiopathic arthritis);HLA-B27was predominantly expressed in spondylarthritis(93%);anti-dsDNA was mainly expressed in systemic lupus erythematosus(67%)and rheumatoid arthritis(25%).CONCLUSION:The positive rates of ANA,ANCA,HLA-B27and anti-dsDNA are different in different immunological-related uveitis,which has a certain diagnostic effect on the classification of immune-related uveitis.

关 键 词：免疫相关性葡萄膜炎 抗原 抗体 诊断 

分 类 号：R773.9[医药卫生—眼科]