5971例抗核抗体阴性病例的抗核抗体谱分析

目的探讨抗核抗体（Antinuclear antibody,ANA）与ANA谱联合检测对自身免疫性疾病的诊断价值。方法对5971例ANA阴性的标本进行ANA谱检测。ANA检测采用欧蒙间接免疫荧光法,ANA谱检测采用欧蒙免疫印迹法。结果在5971例ANA阴性样本中,ANA谱阳性的标本为422例,占7.07%。其中抗SSA抗体、抗SSB抗体、抗Scl-70抗体、抗PM-Scl抗体、抗JO-1抗体、抗细胞周期蛋白抗体（抗PCNA）、抗dsDNA抗体、抗组蛋白抗体（抗His）、抗核糖体P蛋白抗体（抗ARPA）、抗线粒体抗体M2型（抗AMA-M2）阳性率分别为1.46%、0.33%、0.35%、0.35%、0.28%、0.32%、0.83%、0.63%、0.60%和0.75%。抗Ro-52阳性率最高（2.04%）,抗SSA次之（1.46%）。不同年龄组间抗PCNA阳性率差异有统计学意义（P〈0.05）。ANA谱阳性的病例中单项抗体阳性者,女性阳性率高于男性,差异有统计学意义（P〈0.05）。结论为了更准确地诊断自身免疫性疾病,应用ANA进行筛查,并联合应用ANA谱。两者的联合应用有助于对疾病的早期诊断和治疗。

Analysis of the results of antinuclear antibody spectrum for 5971 cases which antinuclear an-tibody were negative

Objective To explore the value of the combined of antinuclear and antibodies(ANA) and antinuclear antibody spectrum(ANAs) in autoimmune disease(AID).Methods A total of 5971 Chinese patients with antinuclear antibodies negative were studied.All of them were detected the ANAs by Europe-Mongolia immunity print,while ANA was measured by Europe-Mongolia indirect immunoflurescence assay.Results There were 422 cases which ANA were negative showed positive in ANAs(7.07%).The positive rate of anti-SSA,anti-SSB,anti-ScL-70,anti-PM-Scl,anti-Jo-1,anti-PCNA,anti-dsDNA,anti-AHA,anti-ARPA,anti-AMA-M2was1.46%,0.33%,0.35%.0.35%,0.28%,0.32%,0.83%,0.63%,0.60% and 0.75% respectively.The positive rate of anti-Ro-52 was the highest(2.04%),and the second one was anti-SSA(1.46%).The frequency of anti-PCNA was associated with patients’age(χ 2 = 6.33,P < 0.05).The positive rate of only one antibody positive in ANAs was statistically higher in female than in male(χ 2 = 6.51,P < 0.05).Conclusion The results in this study suggest screening with both ANA and ANAs can improve the diagnosis of AID.