免疫印迹法和对流免疫电泳法检测ENA抗体的评价和意义

目的 :　评价两种检测可提取性核抗原 (ENA)多肽抗体方法在临床诊断中的价值。方法 :　同时应用免疫印迹法 (IBT)和对流免疫电泳法 (CIE)检测 2 18例结缔组织病 (CTD)患者和 15 0例非结缔组织病对照血清ENA多肽抗体 ,比较两者的检测结果。结果 :　CTD中用IBT法测得抗ENA抗体阳性 14 8例占 6 7.9% ,用CIE法阳性 133例占 6 1.0 % ,两者之间无显著性差异 (P >0 .0 5 )。IBT阳性而CIE阴性为 18例 ,IBT阴性而CIE阳性者 4例。IBT可以同时检测 7种ENA抗体 ,而CIE只能检测 4种ENA抗体 ,但由于两种方法抗原制作过程中某些技术性因素会出现假阴性和假阳性。结论 :　IBT是一种敏感性和特异性高而广谱的ENA血清学诊断方法 ,但同时应用CIE法可以相互补充和验证 ,从而提高抗ENA抗体检测的阳性率。

Comparison between IBT and CIE in the detection of anti- ENA antibodies

Objective: To compare the value of two different techniques for the detection of anti-extractable nuclear antigen (ENA) antibodies. Methods: Immunoblotting technique (IBT) and counter immunoelectrophoresis (CIE) were used to detect antibodies against polypeptides of ENA in 218 patients with connective tissue diseases and 150 non-connective tissue disease controls. Results:In cases of connective tissue diseases, IBT revealed that ENA antibodies was positive in 144 patients (66.10%), while CIE revealed positivity in 130 patients (59.60%), without a significant difference in the two techniques (P>0.05). ENA antibodies were positive in 18 patients when tested with IBT, while tested negative with CIE. ENA antibodies were negative in 4 patients when tested with IBT while positive by CIE. IBT could detect 7 types of antibodies simultaneously while CIE only 4 types. Conclusion: IBT is a sera diagnostic technique to detect ENA antibodies with high sensitivity, specificity and broad spectrum. Combination of IBT and CIE can increase the overall positivity rate of anti-ENA antibodies.