17例抗高尔基体抗体阳性患者的临床特点

目的探讨抗高尔基体抗体(anti-golgi autoantibodies,AGAs)在临床就诊患者中的阳性分布及其相关临床意义。方法对2008年至2013年温州医科大学附属温岭医院用间接免疫荧光法检测AGAs阳性的临床标本进行回顾性分析,并分析AGAs在临床就诊患者中的阳性检出率及AGAs阳性患者的相关临床、实验室特征。结果 AGAs在HEp-2细胞猴肝组织冰冻切片上呈现特征性的荧光模式。在20 471例临床标本中AGAs阳性17例(0.08%),其中女性12例(70.59%),男性5例(29.41%),年龄37~75岁(平均53岁)。17例AGAs阳性者包括自身免疫性疾病(autoimmune diseases,AID)患者6例,慢性乙型肝炎病毒感染相关疾病患者4例,其他疾病患者7例。AGAs阳性滴度范围为1∶100~1∶3200,其中滴度1∶100~1∶320有14例(82.35%),主要见于非AID患者;而滴度为1∶1000~1∶3200的3例患者均见于系统性AID患者(系统性红斑狼疮、类风湿关节炎)。在部分AGAs阳性患者的临床随访中,3例系统性AID患者经11~18月随访后,AGAs持续高滴度;5例非AID临床随访中,3例AGAs转为阴性,2例AGAs未发生明显改变。结论 AGAs阳性可见于多种临床疾病患者,AGAs并非是AID的特征性自身抗体。其高滴度、持续阳性主要见于系统性AID患者,低滴度、短暂阳性主要见于非AID患者。

Clinical Characteristics of 17 Patients with Positive of Anti-Golgi Autoantibodies

Objective To explore the prevalence of the anti-Golgi autoantibodies （AGAs）in the sera of patients and evaluate its potential clinical significance.Methods The positive rate of anti-Golgi autoantibodies in the sera of consecutive patients,come from Wenling hospital from 2008 to 2013 were tested by indirect immunofluorescence for detection of anti-nuclear antibodies （ANA）,and the clinical manifestations and laboratory tests of patients with positive anti-Golgi autoantibodies were retrospective analyzed.Results Typical fluorescence pattern of AGAs was demonstrated in the cytoplasm of HEp-2 cells.Seventeen （0.08％） sera were found to have positive of AGAs among the 20 471 subjects,including 12 （70.59％） female and 5 （29.41％） male age ranged 37 to 75 years （mean 53 years）.Among the 17 subjects with positive AGAs,6 patients with autoimmune diseases （AID）,4 patients were chronically infected with hepatitis B,and 7 patients were with other diseases.The titers of AGAs ranged from 1 ∶ 100 to 1 ∶ 3200,including 14 subjects with the titers between 1∶100-1∶320 whom were diagnosed as non-AID; 3 subjects with the titers between 1 ∶ 1000-1 ∶ 3200 whom were diagnosed as AID.During the follow-up period of patients with positive AGAs,the titers of three patients with AID were persistently high for 11-18 months,while in the five Non-AID patients,the titers of two patients did not show obvious change,and three patients turned negative.Conclusion Positive AGAs can be found in many diseases and AGAs are not AID-specific.High-titers and persistent positive AGAs are in patients with AID,whereas low-titers and transient positive AGAs are in patients with non-AID.