抗中心粒细胞胞浆抗体检测在儿科疾病中的应用  

The application of anti-neutrophil cytoplasmic antibodies tests in pediatric diseases

作　　者：康郁林[1] KANG Yulin(Department of Nephrology and Rheumatology,Shanghai Children's Hospital,School of Medicine,Shanghai Jiao Tong University,Shanghai 200062,China)

机构地区：[1]上海市儿童医院上海交通大学医学院附属儿童医院肾脏风湿科,上海200062

出　　处：《临床儿科杂志》2022年第10期733-738,共6页Journal of Clinical Pediatrics

摘　　要：抗中性粒细胞胞浆抗体(ANCA)是一类以中性粒细胞和单核细胞胞浆成分为靶抗原的自身抗体。ANCA包括胞浆型(c-ANCA)、核周型(p-ANCA)和非典型(a-ANCA)。其中c-ANCA、p-ANCA的靶抗原分别是蛋白酶3和髓过氧化物酶。目前ANCA检测技术主要包括间接免疫荧光法、酶联免疫吸附法、化学发光法和荧光酶免疫法等。ANCA相关性血管炎是一种主要累及中小血管的坏死性血管炎,寡或无免疫复合物沉积,儿童发病率低,但起病急,进展快,临床表现多样化,停药后疾病易复发。ANCA已成为诊断儿童肉芽肿性血管炎、显微镜下血管炎和嗜酸性粒细胞肉芽肿性血管炎等系统性血管炎的重要标记物。ANCA检测有助于ANCA相关性血管炎的早期诊治,从而改善疾病预后。Anti-neutrophil cytoplasmic antibodies(ANCA)are a class of autoantibodies that target the cytoplasmic components of neutrophils and monocytes.ANCA includes cytoplasmic ANCA(c-ANCA),perinuclear ANCA(p-ANCA)and atypical ANCA(a-ANCA).The target antigens of c-ANCA and p-ANCA are proteinase 3 and myeloperoxidase,respectively.At present,the ANCA detection assay mainly includes indirect immunofluorescence,enzyme-linked immunosorbent assay,chemiluminescent immunoassays and fluorescent-enzyme immunoassays.ANCA associated vasculitis(AAV)is a necrotizing vasculitis mainly involving small and medium sized arteries with pauci-immune deposits.The incidence of AAV is low in children,but the onset of the disease is urgent,the progression is rapid,the clinical manifestations are diverse,and the disease is easy to relapse after drug withdrawal.ANCA has become an important marker for the diagnosis of granulomatous vasculitis,microscopic vasculitis and eosinophilic granulomatous vasculitis.ANCA detection is helpful for the early diagnosis and treatment of AAV,thus improving the prognosis of the disease.

关 键 词：抗中心粒细胞胞浆抗体 蛋白酶3 髓过氧化物酶 ANCA相关性血管炎 

分 类 号：R725.9[医药卫生—儿科] R446.6[医药卫生—临床医学]