致密细斑点型抗核抗体在系统性自身免疫性风湿性疾病诊断中的意义  

Role of anti-nuclear antibody-dense fine speckled pattern for diagnosing systemic autoimmune rheumatic disease

作　　者：杨可可 吴俊渊[1] 曹兴建[1] YANG Keke;WU Junyuan;CAO Xingjian(Department of Clinical Laboratory,the First People's Hospital of Nantong,Nantong 226001,Jiangsu,China)

机构地区：[1]南通市第一人民医院检验科,江苏南通226001

出　　处：《检验医学》2021年第7期691-695,共5页Laboratory Medicine

基　　金：南通市卫生和计划生育委员会科研基金项目(wkzl2018003)。

摘　　要：目的探讨致密细斑点型抗核抗体在系统性自身免疫性风湿性疾病(SARD)诊断中的价值。方法选取1683例疑似或确诊为SARD的患者,分别用间接免疫荧光法(IIF)检测抗核抗体,免疫印迹法检测自身抗体。对IIF阳性、免疫印迹法阴性和2种方法均阳性的样本进行抗核抗体核型分析。采用秩相关分析评价致密细斑点型抗核抗体滴度与SARD的相关性。结果IIF检测抗核抗体的阳性率与免疫印迹法检测自身抗体的阳性率比较,差异无统计学意义(P=0.155)。在72例IIF阳性、免疫印迹法阴性样本中,核颗粒型、致密细斑点型、均质型和核仁型所占比例分别为44.44%、40.28%、12.50%、2.78%。致密细斑点型所占比例与核颗粒型比较、差异无统计学意义(P=0.701);与均质型、核仁型比较,差异均有统计学意义(P=0.001、P<0.001)。致密细斑点型抗核抗体的荧光滴度与SARD无相关性(r=-0.300,P=0.667)。644例2种方法均阳性的样本中,无致密细斑点型抗核抗体阳性。结论致密细斑点型抗核抗体阳性或可用于排除SARD。Objective To investigate the role of anti-nuclear antibody(ANA)-dense fine speckled pattern in the diagnosis of systemic autoimmune rheumatic disease(SARD).Methods A total of 1683 samples from suspected or diagnosed patients suffering from SARD were determined for ANA by indirect immunofluorescence(IIF)and anti-extractable nuclear antigen antibody(ENA)by immunoblotting test.The identifications of ANA type were performed on samples positive by IIF but negative by immunoblotting test and both positive by IIF and immunoblotting test.The correlation of ANA-dense fine speckled pattern and the occurrence of SARD was evaluated by rank correlation analysis.Results There was no statistical significance between the positive rates by IIF-ANA and immunoblotting test-ENA(P=0.155).In 72 samples only positive by IIF,the common speckled pattern accounted for 44.44%,and dense fine speckled pattern accounted for 40.28%without statistical significance(P=0.701).The homogeneous pattern(12.50%)and nucleolus pattern(2.78%)showed statistical significance with dense fine speckled pattern(P=0.001,P<0.001).There was no correlation between dense fine speckled pattern and SARD(r=-0.300,P=0.667).Dense fine speckled pattern appeared in none of the 644 samples both positive by IIF-ANA and immunoblotting test-ENA.Conclusions The positive ANA-dense fine speckled pattern may be applied in excluding SARD.

关 键 词：致密细斑点型抗核抗体 自身抗体 系统性自身免疫性风湿性疾病 

分 类 号：R446.1[医药卫生—诊断学]