血清IgG及IgG4检测在ANCA相关性血管炎中的诊断价值  

Diagnostic value of serum IgG and IgG4 in antineutrophil cytoplasmic antibody associated vasculitis

作　　者：秦陈浩[1] 顾爱萍[1] 展富琴[1] 冯萍[1] 顾昊宇 何春燕[1] 杨顺[1] QIN Chenhao;GU Aiping;ZHAN Fuqin;FENG Ping;GU Haoyu;HE Chunyan;YANG Shun(Department of Medical Laboratory, the Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu Province, 215004, China)

机构地区：[1]苏州大学附属第二医院检验科

出　　处：《第三军医大学学报》2019年第15期1497-1500,共4页Journal of Third Military Medical University

摘　　要：目的研究分析血清IgG及IgG4在ANCA相关性血管炎(AAV)患者中的表达,探讨IgG4在AAV中的诊断价值。方法收集本院就诊的AAV患者血清48例为患者组,同期健康人血清25例作为对照组,用ELISA法检测IgG4浓度,免疫比浊法检测IgG浓度,船式ELISA法检测抗髓过氧化物酶抗体(anti-MPO)和抗蛋白酶3抗体(anti-PR3)浓度,两组数据间比较用t检验,多组数据用单因素方差分析,两两间比较用LSD-t检验,两组间指标相关性分析用Pearson相关性分析,以P<0.05为差异有统计学意义。结果AAV患者组血清IgG4浓度为(1.17±0.58)g/L,IgG4/IgG为(10.12±6.64)%,明显高于健康对照组,差异有统计学意义(P<0.01);MPO-ANCA相关性AAV和PR3-ANCA相关性AAV患者组的血清IgG4浓度及IgG4/IgG较健康对照组均有明显升高(P<0.01),但两个亚型之间的IgG4表达没有差异(P>0.05),ANCA浓度与IgG4浓度也没有明显相关性(P>0.05)。结论AAV或其亚型患者的IgG4浓度及IgG4/IgG均有明显升高,但与ANCA的类型及其浓度没有明显相关性,IgG4联合ANCA检查有助于AAV的诊断。Objective To investigate the expression of serum IgG and IgG4 in the patients with antineutrophil cytoplasmic antibody(ANCA)-associated vasculitis(AAV),and explore the diagnostic value of IgG4 in AAV patients.Methods A total of 48 patients with AAV admitted in our hospital from July 2016 to June 2018 were recruited as patient group,and 25 healthy persons during the same period were subjected as control group.Their serum samples were collected for concentration of IgG4 by ELISA,that of IgG by immunoturbidimetric assay,and those of anti-MPO and anti-PR3 antibodies by ship type ELISA.Student’s t test was used to make data comparison between the 2 groups,one-way ANOVA was employed for comparison among the multiple groups,and LSD-t test was applied for intragroup comparison.Pearson correlation analysis was used to analyze the correlation between the 2 groups,and P<0.05 was considered statistically.Results The serum IgG4 concentration was 1.17±0.58 g/L,and the percentage of IgG4 to IgG was(10.12±6.64)%in the AAV patients,which were significantly higher than those of healthy individuals(P<0.01).So were the concentrations in the MPO-ANCA-associated and PR3-ANCA-associated AAV patients(P<0.01).But there was no difference in the expression of IgG4 between the 2 subtypes(P>0.05),and there was no significant correlation between ANCA concentration and IgG4 concentration(P>0.05).Conclusion IgG4 concentration and IgG4/IgG percentage are significantly increased in the patients with AAV or its subtypes.But there is no significant correlation with the types and ANCA concentration.Detection of IgG4 combined with ANCA is helpful in the diagnosis of AAV.

关 键 词：IGG4 IgG4相关疾病 ANCA相关性血管炎 抗髓过氧化物酶抗体 抗蛋白酶3抗体 

分 类 号：R392.11[医药卫生—免疫学] R446.112[医药卫生—基础医学]