抗核抗体与特异性自身抗体在自身免疫性疾病诊断中的价值  

The value of antinuclear antibody and specific autoantibodies in the diagnosis of autoimmune diseases

作　　者：刘伟[1] 田鹏飞[1] 郭珊[1] 李冰[1] LIU Wei;TIAN Peng-fei;GUO Shan;LI Bing(Clinical Laboratory,Xinxiang Central Hospital,Xinxiang,Henan 453000,China)

机构地区：[1]新乡市中心医院检验科,河南新乡453000

出　　处：《中国卫生检验杂志》2020年第15期1801-1803,共3页Chinese Journal of Health Laboratory Technology

摘　　要：目的探讨抗核抗体(ANA)与特异性自身抗体在自身免疫性疾病(AID)诊断的价值。方法回顾性分析2017年6月-2018年10月本院就诊的1053例申请自身抗体谱检测患者,根据临床诊断是否为AID,分为AID组和非AID组。两组患者均采集3 ml清晨空腹静脉血,离心分离得到血清标本,同时检测两组患者血清标本的ANA和特异性自身抗体,对两组检测结果进行记录分析。结果单独检测患者ANA时,诊断AID的灵敏度为82.68%,特异度为66.09%;单独检测患者特异性自身抗体时,诊断AID灵敏度为58.47%,特异度为83.92%。当联合检测ANA和特异性自身抗体时,共有633例患者检测结果相同,其诊断AID的灵敏度为82.60%,特异度为93.88%,阳性预测值为93.96%,阴性预期值为82.39%。198例ANA和特异性自身抗体检测结果不一致的AID患者中,诊断为类风湿性关节炎(RA)共有115例,占58.08%;当结果为IIF(+)LIA(-)时诊断RA的人数远高于IIF(-)LIA(+);结果为IIF(-)LIA(+)时,均无人诊断为SLE、AIHA、ITP。结论ANA检测的灵敏度较高,而特异性自身抗体检测的特异度较高,联合ANA和特异性自身抗体检测能提高AID的诊断率。Objective To investigate the value of antinuclear antibody(ANA)and specific autoantibodies in the diagnosis of autoimmune diseases(AID).Methods A retrospective analysis was made on 1053 patients who applied for autoantibody spectrum test in our hospital from June 2017 to October 2018.They were divided into AID group and non-AID group according to the clinical diagnosis of AID.The fasting venous blood was collected in the morning for 3 ml in both groups,and serum samples were separated by centrifugation.At the same time,the serum samples of the two groups were detected for their ANA and specific autoantibodies,and the results of the two groups were recorded and analyzed.Results The sensitivity and specificity of diagnosing AID were respectively 82.68%and 66.09%when ANA was detected alone,and 58.47%and 83.92%respectively when specific autoantibodies were detected alone.When the combined detection of ANA and specific autoantibodies was performed,the results were same in the 633 patients.The sensitivity,specificity,positive predictive value and negative predictive value were respectively 82.60%,93.88%,93.96%and 82.39%.Among 198 AID patients with inconsistent results of ANA and specific autoantibodies,115 were diagnosed as rheumatoid arthritis(RA),accounting for 58.08%.When the result was IIF(+)LIA(-),the number of diagnosed RA was much higher than that of IIF(-)LIA(+).When the result was IIF(-)LIA(+),no one was diagnosed as SLE,AIHA,ITP.Conclusion The sensitivity of ANA detection is high,and the specificity of specific autoantibody detection is high.The combined detection of ANA and specific autoantibody can improve the diagnostic rate of AID.

关 键 词：抗核抗体 特异性自身抗体 自身免疫性疾病 诊断价值 

分 类 号：R593.2[医药卫生—内科学]