炎症性肠病相关抗体检测的临床价值研究  

Clinical Value of Inflammatory Bowel Disease Related Antibody Detection

作　　者：胡惠静[1] 吴晓岩[1] 许兴路 杜英[1] 胡晓丽[3] HU Huijing;WU Xiaoyan;XU Xinglu;DU Ying;HU Xiaoli(Department of Laboratory Diagnosis,Heilongjiang Provincial Hospital,Harbin Heilongjiang 150036,China;Department of Radioimmunology,Heilongjiang Provincial Hospital,Harbin Heilongjiang 150036,China;Department of Infectious Medicine,Heilongjiang Provincial Hospital,Harbin Heilongjiang 150036,China)

机构地区：[1]黑龙江省医院实验诊断部,黑龙江哈尔滨150036 [2]黑龙江省医院放射免疫特检科,黑龙江哈尔滨150036 [3]黑龙江省医院感染内科,黑龙江哈尔滨150036

出　　处：《中国继续医学教育》2020年第11期74-77,共4页China Continuing Medical Education

摘　　要：目的研究炎症性肠病(IBD)相关抗体IgA和IgG型抗小肠杯状细胞抗体(GAb)、抗中性粒细胞胞浆抗体(pANCA)、抗胰腺腺泡抗体(PAb)和抗酿酒酵母抗体(ASCA)检测的临床价值。方法收集2016年11月-2019年1月黑龙江省医院溃疡性结肠炎(UC)144例、克罗恩病(CD)38例、IBD类型待定32例和结肠息肉36例,间接免疫荧光法检测抗体在患者血清中的表达。结果GAb-IgG在IBDU组阳性率75.0%,IgA/IgG型pANCA在UC组阳性率为30.6%和50.0%,ASCA-IgA在CD组和IBDU组阳性率为42.1%和43.8%,差异具有统计学意义;GAb-IgA、IgA/IgG型PAb、ASCA-IgG阳性率低,差异无统计学意义。GAb-IgA、IgA/IgG型pANCA诊断UC的特异性为100.0%,GAb-IgG为66.7%;PAb-IgA、IgA/IgG型ASCA诊断CD的特异性为100.0%,PAb-IgG为94.4%。结论IgA/IgG型pANCA在UC组阳性率高,ASCA-IgA在CD组阳性率高;GAb-IgG和ASCA-IgA在IBDU组阳性率高。GAb-IgA、IgA/IgG型pANCA诊断UC的特异性高,GAb-IgG特异性偏低;PAb和ASCA诊断CD的特异性高。除GAb-IgG外,IBD相关抗体特异性都很高,阳性能够提示IBD可能。Objective To study the clinical value of anti-intestinal goblet cell antibody(GAb), pernuclear anti-neutrophil cytoplasmic antibody(pANCA), anti-pancreatic antibody(PAb) and anti-saccharomyces cerevisia antibody(ASCA) in inflammatory bowel disease(IBD). Methods Serum samples were obtained from 144 patients with ulcerative colitis(UC), 38 patients with Crohn’s disease(CD), 32 patients with inflammatory bowel disease unclassified(IBDU), 36 patients with colon polyps(control) in Heilongjiang Provincial Hospital from November 2016 to January 2019. The serum levels of IgA/IgG GAb, pANCA, PAb, ASCA were detected by indirect immunofluorescence method. Results The positive rate of GAb-IgG in IBDU groups was 75.0% with significant difference. The positive rates of pANCA-IgA and pANCA-IgG were 30.6% and 50.0% with significant difference in the UC group. The positive rates of ASCAIgA were 42.1% and 43.8%, with significant difference in CD and IBDU groups. The positive rates of GAb-IgA, PAb-IgA, PAb-IgG and ASCAIgG were low, without significant difference in UC, CD and IBDU groups. The specificityof GAb-IgA, pANCA-IgA and pANCA-IgGfor the diagnosis of UC were 100.0%, then the specificityof GAb-IgG was 66.7%. The specificity, of PAb-IgA, ASCA-IgA and ASCA-IgG for the diagnosis of CD were 100%, then the specificity of PAb-IgG was 94.4%. Conclusions The positive rates of pANCA-IgA and pANCA-IgG were higher in the UC group;the positive rate of ASCA-IgA was higher in the CD group;the positive rates of GAb-IgG and ASCA-IgA were higher in the IBDU group. GAb-IgA, pANCA-IgA, pANCA-IgG have high diagnostic specificity for UC and PAb, ASCA for CD. In addition to GAb-IgG, other antibodies have good specificity, and positive can indicate the possibility of IBD.

关 键 词：炎症性肠病 抗体检测 抗小肠杯状细胞抗体 抗中性粒细胞胞浆抗体 抗胰腺腺泡抗体 抗酿酒酵母抗体 

分 类 号：R446[医药卫生—诊断学]