临床就诊患者抗核抗体和抗核抗体谱检测结果分析

目的比较间接免疫荧光法(IIF)筛查抗核抗体(ANA)与线性免疫印迹法(LIA)检测抗核抗体谱(ANAs)特异性抗体结果不一致性，分析二者的相互关系及临床意义。方法采用间接免疫荧光法与线性免疫印迹法对871份血清标本进行抗核抗体检测，检测结果可分为自身免疫病组(AID)和非AID组，并分析结果的相互关系和临床意义。结果IIF法与LIA法检测抗核抗体的阳性率分别为21.01%和15.50%，差异有统计学意义(χ2=12.64，P<0.01)，IIF法阳性者中以均质型(34.4％)，颗粒型(33.9％)和胞质颗粒型(17.5％ )多见。LIA法中阳性抗体出现较多的是抗SSA，抗Ro-52等。ANA和ANAs在自身AID患者中的阳性率分别是96.4%和73.2%，显著高于非AID患者(13.1%和8.1%)；ANA和ANAs在AID组和非AID组间阳性率比较，差异有统计学意义(P<0.01)。结论间接免疫荧光法是良好的筛查试验，ANA核型与ANAs相结合对自身免疫性疾病的诊断与鉴别诊断有重要意义；临床诊断中，IIF筛查ANA应与LIA检测ANAs同时进行，以避免单一方法检测导致AID患者的漏诊。

Analysis of Antinuclear Antibody and Antinuclear Antibody Spectrum Test for the Clinical Medical Patients

ObjectiveTo compare the inconsistent result of the indirect immunofluorescence (IIF) assay screening for antinuclear antibody (ANA) and linear immunoblot assay (LIA) for antinuclear antibody spectrum (ANAS) specific antibody，and evaluate the relationship and clinical significance．Methods871 cases of consecutive clinical samples for ANA testing were tested by IIF and LIA for the detection of specific ANA antibodies．All the samples were divided into autoimmune diseases(AID) group and non-AID group．The relationship between different test results and their clinical significance were analyzed．ResultsThe positivity rate of ANA detected by IIF and LIA was significantly different(21.01% and 15.50%，respectively，χ2=12.64，P<0.01)．Homogenous (34.4％)，Nuclear speckled (33.9％) and cytoplasmic speckled (17.5％) pattern were common in 183 positive ANA-IIF findings．The most frequently occurred antibody was anti-SSA and anti-Ro52．The positive rates of ANA and ANAs in the patients with autoimmune diseases were 96.4% and 73.2%，obviously higher than 13.1% and 8.1% in the patients with non-autoimmune diseases．The difference in positive rates of ANA and ANAs between the autoimmune disease group and the non-self-immune disease group had statistical significance(P<0.01)．ConclusionANA-IIF is a good screening test．The combination of ANA-IIF and ANAs-LIA may be useful for the diagnosis and differential diagnosis of AID．In the clinical diagnosis of AID，IIF screening for ANA should be simultaneously with the LIA-ANAs to avoid the missing diagnosis of AID patients．