87 例抗核抗体斑点型阳性患者血清特异性抗核抗体谱分析

目的探讨血清斑点型抗核抗体（ANA）与特异性抗核抗体谱（ANAS）中不同项目阳性组合之间的相关性。方法分析87例斑点型ANA阳性病例的抗ANAS（抗Ul-nRNP、Sm、SS-A、SS—B、Scl-70、Jo-1、SCL-70、PM—Scl、centromereB、nukleosome、PCNA、ds—DNA、histones、ribosomal—Pprotein、AMA-M2抗体）多肽谱类型。结果斑点型ANA的特异性ANAS不同项目阳性组合类型达到23种，除SCL-70、PM—Scl外，其他13种特异性ANAS成分均见阳性。ds—DNA阴性的histone、Sm、nukleosome、PCNA、Rib-P．P单独阳性或合并其他抗体阳性率高达19．5％（17／87），联合检测这些抗体能提高系统性红斑狼疮（SLE）诊断的敏感性。ANAS阳性率与ANA滴度之间没有绝对关系。结论不能简单地依据荧光核型来推断抗ANAS抗体的具体类型；多项指标联合检测能提高诊断疾病的敏感性和特异性；斑点型ANA低滴度时也应作特异性ANAS检测。

Analysis of the specific antinuclear antibody profile in patients with positive speckled antinuelear antibodies

Objective To investigate the correlation between the positive combinations of different items in antinuclear antibody speckled pattern in serum and those in specific antinuclear antibody profile.Methods Contrast analysis was carried out to detect the type of anti-ANA profile(including antibodies to U1-Nrnp,Sm,SS-A,SS-B,Scl-70,Jo-l,SCL-70,PM-Scl,centromere B,nukleosome,PCNA,ds-DNA,histones,ribosomal-P protein and AMA-M2)of 87 cases with positive speckled antinuclear antibodies.Results There were 23 types of positive combinations of different items in the ANA profile of speckled antinuelear antibody.And 13 types of the specific antinuclear antibodies were positive,except SCL-70 and PM-Scl.The positive rates of single antibodies and their comhinations (including histone with negative ds-DNA,Sm,nukleosome,PCNA,Rib-P.P)could reach as high as 19.5%(17/87).The sensitivity of diagnosis for systemic lupus erythematosus(SLE)would be increased through examining these antibodies together.There was no significant association between the positive rates of the ANA profile and the titer of antinuclear antibody.Conclusion The specific type of anti-ANAs antibodies cannot be predicated simply according to the fluorimetrie caryotypo.Combined examination of multiple approaches can increase the sensitivity and specificity of diagnosis for SLE.Specific antinuclear antibody profile should be,analyzed in the patients with low titer of speckled antinuclear antibodies.