抗核抗体联合抗核抗体谱检测在自身免疫性疾病诊断中的应用

目的 探讨抗核抗体(ANA)联合抗核抗体谱(ANAs)检测在自身免疫性疾病(AID)诊断中的应用价值.方法 选择漳州市中医院2017年2月—2019年10月收治的98例AID患者作为AID组,按疾病类型分为6个亚组,分别为系统性红斑狼疮(SLE)组32例,类风湿性关节炎(RA)组34例,干燥综合征(SS)组13例,进行...

Application of antinuclear antibody combined with antinuclear antibody spectrum in diagnosis of autoimmune disease

Objective To explore the application value of antinuclear antibody(ANA)combined with antinuclear antibody spectrum(ANAs)in diagnosis of autoimmune disease(AID).Methods The 98 AID patients admitted to Zhangzhou Hospital of Traditional Chinese Medicine from February 2017 to October 2019 were selected as AID group.According to the type of disease,the patients were divided into six subgroups such as systemic lupus erythematosus(SLE)group(32 cases),rheumatoid arthritis(RA)group(34 cases),Sjogren syndrome(SS)group(13 cases),progressive systemic sclerosis(PSS)group(7 cases),mixed connective tissue disease(MCTD)group(6 cases)and allergic purpura(AP)group(6 cases).Other 98 patients without AID were selected as non-AID group.The positive expression of ANA and ANAs in each group and ANA karyotype and expression in AID group was analyzed.Results The positive rate of ANA in SLE group was the highest[93.75%(30/32)],followed by MCTD,SS,PSS and RA groups,which were significantly higher than that in non-AID group[83.33%(5/6),76.92%(10/13),71.43%(5/7),35.29%(12/34)vs.5.10%(5/98)],with significant differences(all P<0.05).The positive rates of anti SmDl,anti Ul-Sn RNP,anti dsDNA,anti SSA,anti SSB,anti histone and anti nucleosome in SLE group were significantly higher than those in non-AID group;the positive rates of anti SSA and anti histone in RA group were significantly higher than those in non-AID group;the positive rates of anti SSA and anti SSB in SS group were significantly higher than those in non-AID group;the positive rate of anti Scl-70 in PSS group was significantly higher than that in non-AID group.The positive rates of anti Rib-P,anti SmDl,anti Ul-Sn RNP and anti SSA in MCTD group were significantly higher than those in non-AID group,with significant differences(all P<0.05).In AID group,the total positive rate of ANA was higher than that of ANAs[64.29%(63/98)vs.58.16%(57/98)],without significant difference(P>0.05).In 47 cases with positive ANA and ANAs,the karyotype analysis showed that the nuclear homogeneity was mainly anti dsDNA,anti nucleosome and anti histone,most of the nuclear particles were anti dsDNA,anti histone and anti SSB,and the other karyotypes were rare.Conclusions ANA can assist in the diagnosis of AID,but the specificity is not good.ANA combined with ANAs diagnosis can improve the accuracy of clinical diagnosis and guide the treatment.