抗核抗体与抗可提取性核抗原抗体在初诊免疫性血小板减少症患儿中的临床意义  

Clinical significance of antinuclear antibody and anti-extractable nuclear antigen antibody in children with newly diagnosed immune thrombocytopenia

作　　者：刘正红 徐之良[1] Liu Zhenghong;Xu Zhiliang(Department of Pediatrics,Renmin Hospital of Wuhan University,Wuhan 430060,China)

机构地区：[1]武汉大学人民医院儿科,武汉430060

出　　处：《中国医学前沿杂志（电子版）》2021年第9期94-98,共5页Chinese Journal of the Frontiers of Medical Science(Electronic Version)

摘　　要：目的探讨抗核抗体(antinuclear antibody,ANA)与抗可提取性核抗原抗体(anti-extractable nuclear antigen antibody,抗ENA抗体)在初诊免疫性血小板减少症(immune thrombocytopenia,ITP)患儿中的临床意义。方法选取2018年9月至2019年7月于武汉大学人民医院初诊为ITP的68例患儿纳入试验组,将同期于该院接受常规体检的35例健康儿童纳入对照组,检测两组儿童ANA和抗ENA抗体,试验组患儿经规范治疗后,分析其临床疗效、疾病复发、转归与ANA和抗ENA抗体的关系。结果试验组患儿ANA、抗双链DNA抗体(anti-double strand DNA antibody,抗dsDNA抗体)、抗干燥综合征A抗原抗体(anti-Sjogren syndrome A antibody,抗SSA抗体)、抗干燥综合征B抗原抗体(anti-Sjogren syndrome B antibody,抗SSB抗体)和抗核糖核蛋白抗体(anti-ribonucleoprotein antibody,抗RNP抗体)阳性率均显著高于对照组(均P<0.05),两组儿童抗核糖体P蛋白抗体(anti-ribosomal P-protein autoantibody,抗Rib-P抗体)、抗史密斯抗体(anti-Smith antibody,抗Sm抗体)、抗Jo-1抗体、抗硬皮病70抗体(anti-scleroderma-70 antibody,抗Scl-70抗体)阳性率比较差异均无统计学意义(均P>0.05)。ANA阳性患儿年龄显著大于ANA阴性患儿(P<0.05),女性、重型ITP、发展为慢性ITP的占比均显著高于ANA阴性患儿(均P<0.05)。试验组中56例患儿治疗有效,纳入有效组,其余12例患儿纳入无效组,两组患儿ANA、抗dsDNA抗体、抗Rib-P抗体、抗Sm抗体、抗SSA抗体、抗SSB抗体、抗RNP抗体和抗Scl-70抗体阳性率比较差异均无统计学意义(均P>0.05)。随访1~2年,ANA阳性和阴性患儿复发率比较差异无统计学意义(P>0.05),ANA阳性患儿发展为慢性ITP的占比显著高于ANA阴性患儿(P<0.05)。结论初诊ITP患儿ANA、抗ENA抗体阳性率较高,且多见于年龄较大的女性患儿,ANA和抗ENA抗体阳性对ITP患儿短期治疗效果无明显影响,但ANA可作为慢性ITP的预测因素。Objective To explore the clinical significance of antinuclear antibody(ANA)and anti-extractable nuclear antigen(ENA)antibodies in children with newly diagnosed immune thrombocytopenia(ITP).Method A total of 68 cases of newly diagnosed ITP children who were treated in Renmin Hospital of Wuhan University from September 2018 to July 2019 were selected as experimental group,and 35 healthy children who underwent routine physical examination during the same period in that hospital were included in control group.The two groups of subjects were tested for ANA and anti-ENA antibodies.Children in experimental group after standard treatment,the relationship between clinical efficacy,disease recurrence,outcome and ANA and anti-ENA antibodies were analyzed.Result The positive rate of ANA,anti-double strand DNA(anti-dsDNA)antibody,anti-Sjögren syndrome A(anti-SSA)antibody,anti-Sjögren syndrome B(anti-SSB)antibody,and anti-ribonucleoprotein(anti-RNP)antibody in experimental group were significantly higher than those in control group(all P<0.05),there were no statistically significant differences in the positive rates of anti-ribosomal P-protein(anti-Rib-P)antibody,anti-Smith(anti-Sm)antibody,anti-Jo-1 antibody,and anti-scleroderma-70(anti-Scl-70)antibody(all P>0.05).The age of ANA positive children was significantly higher than those of ANA negative children(P<0.05),and the proportion of females,severe ITP and developing chronic ITP were significantly higher than those of ANA negative children(all P<0.05).In experimental group,56 children were treated effectively and were included in effective group,and the remaining 12 children were included in ineffective group.There were no statistically significant differences in the positive rates of ANA,anti-dsDNA antibody,anti-Rib-P antibody anti-Sm antibody,anti-SSA antibody,anti-SSB antibody,anti-RNP antibody,and anti-Scl-70 antibody between the two groups(all P>0.05).After 1~2 years of follow-up,there was no significant difference in the recurrence rate between ANA positive and nega

关 键 词：抗核抗体 抗可提取性核抗原抗体 免疫性血小板减少症 儿童 

分 类 号：R725.5[医药卫生—儿科]