自身抗体检测在儿童人群中的应用

目的探讨自身抗体在特定人群中的阳性分布,给临床自身免疫性疾病诊断提供依据。方法用间接免疫荧光法和免疫斑点法分别测定抗核抗体(ANA)、抗双链DNA抗体(dsDNA)和ENA(Sm、RNP、SSA、SSB、Jo-1、Scl-70)。结合临床资料分析ANA在不同年龄、不同性别、不同疾病中的阳性分布趋势及临床应用价值。结果儿童自身免疫性疾病以系统性红斑狼疮(SLE)为主,儿童自身抗体阳性以ANA为主。SLE患儿ANA滴度较高,11例中有9例为1∶1000,而过敏性紫癜(HSP)、血小板减少性紫癜(ITP)、无临床症状组ANA滴度较低;SLE患儿组ANA阳性率随年龄增加而增加,HSP、ITP、无临床症状组ANA阳性率在不同年龄人群中无明显示变化。SLE患儿组女性明显示大于男性,HSP、ITP无临床症状组无明显性别差异。结论年龄和滴度可用于儿童SLE和其他风湿性疾病的鉴别诊断。

Application of Autoantibody determination in Children

[Objective]to investigate the distribution of autoantibody positive in specific population,and provide evidence for clinical diagnosis of autoimmune disease.[Methods]Indirect immunofluorescence and dot immunobinding assay were adopted for determination of anti-nuclear antibodies（ANA）,anti-double-stranded DNA antibodies（dsDNA） and ENA（Sm,RNP,SSA,SSB,Jo-1,Scl-70）.The ANA positive distribution trends in different age,gender,diseases and the clinical value were analyzed with clinical data.[Results]The major autoimmune disease was systemic lupus erythematosus（SLE）,the main positive autoantibody was ANA.ANA titer was higher in children with SLE,it in 9 of 11 patients was 1∶1000,ANA titer was lower in group of Henoch Schonlein Purpura（HSP）,thrombocytopenic purpura（ITP）,no clinical symptom;ANA positive rate increased in SLE patients group with age.ANA positive rate did not change significantly in group of HSP,ITP and no clinical symptom.Female SLE patients was significantly older than male,which gender difference was not significant in group of HSP,ITP and no clinical symptom.[Conclusion]Age and titer can be used for differential diagnosis of SLE and other rheumatic diseases of children.