健康体检人群与临床就诊人群抗核抗体谱分布状况对比分析

目的通过横向对比健康体检人群与临床就诊人群抗核抗体（ANA）谱分布状况，分析ANA谱检测在健康体检和医学检查中的差异及重要意义，为阳性人群的纵向追踪打下基础。方法采用间接免疫荧光法（IIF）检测ANA，每个工作日提取新鲜血清，严格按试剂说明书操作；采用欧蒙印迹ANA谱3试剂检测15项特异性抗体；结果比较采用SPSSl7．0统计软件进行统计分析。结果健康体检人群ANA滴度〉1：100阳性率14．1％，滴度〉1：320阳性率5．9％，临床就诊人群ANA滴度〉1：100阳性率43．3％，滴度〉1：320阳性率22．4％；两组人群相同滴度阳性率比较差异有统计学意义。两组人群同一性别ANA阳性率随年龄分布趋势基本一致，不同性别差异较大，男性随年龄呈平缓上升趋势，女性则在青春期与更年期出现两个峰值。两人群15项特异性抗体出现频率就诊人群显著偏高，频率排序差异也较大，与原发性胆汁性肝硬化相关联抗体，抗-M2抗体在体检人群出现频率与就诊人群较接近。结论健康体检人群与临床就诊人群ANA谱阳性率有明显差异；ANA阳性率不同性别随年龄变化趋势不同；15项特异性抗体两人群分布差异较大；高危人群筛查ANA谱对自身免疫病的早期发现、早期防御具有重要价值。

Antinuclear antibody in health check-up and clinical visit adults

Objective To learn the distribution of antinuclear antibodies （ANAs） in health check- up and the clinical visit populations, so as to provide evidence for the follow-up study of ANA positive individuals. Methods ANAs were measured by using indirect immunofluorescence assay （IIF）. Fresh serum was extracted in accordance with reagent instructions each day. Fifteen specific antibodies were detected by Euroimmun blot. SPSS17.0 statistical software was used for data analysis. Results （ 1 ） For ANA 〉 1： 100,the positive rate in health check-up or clinical visit population was 14. 1% vs 43.3%. However,for ANA 〉 1： 320,the positive rate in health check-up or clinical visit population was 5.9% vs 22. 4%. （2） In the two tilter groups, ANA positive rate was consistent in different age groups. There were statistically significant differences of ANA positive rate in different gender groups： a smooth upward trend with age was found in male; however,two peaks were identified in female during the period of puberty and menopause. （3） The frequency of occurrence of fifteen specific antibodies was higher in the clinical visit group, although the occurrence of anti-M2 showed no difference between the two groups. Conclusions This investigation found a significant difference in ANA positive rate between health check-up populations and clinical visit patients. The positive rate of ANA may be changed with gender and age. ANAs screening in high risk populations could be important for the early diagnosis and intervention of autoimmune diseases.