抗核抗体核型与条带免疫抗体谱相关性分析

目的分析抗核抗体(antinuclear antibody,ANA)与抗核抗体谱(antinuclear antibodies,ANAs)的相关性。方法 2 500例疑似或已确诊自身免疫性风湿性疾病患者,采用间接免疫荧光法检测ANA,其中826例同时应用条带免疫分析法行ANAs分析。结果 ANA阳性1 300例,同时行ANAs的826例患者中ANA(+)/ANAs(+)182例(22.03%),ANA(-)/ANAs(-)529例(64.04%),ANA(+)/ANAs(-)111例(13.43%),ANA(-)/ANAs(+)4例(0.50%);ANA阳性者中以颗粒型(62.2%)、胞质颗粒型(13.3%)、均质型(9.7%)、核仁型(8.9%)多见,颗粒型多见SSA/Ro52抗体,均质型多见dsDNA抗体,胞质颗粒型多见AMA-M2;ANAs的阳性率随ANA滴度增大而升高;当滴度为1∶800以上时,>20～40岁组ANA阳性率明显高于其他各年龄组(P<0.01)。结论 ANA-间接免疫荧光法是良好的筛查实验,ANA核型、滴度与ANAs相结合对自身免疫性风湿性疾病的诊断与鉴别诊断有重要意义。

Correlation of antinuclear antibody immunofluorescence patterns with immune profile using line immunoassay

Objective To investigate the correlation between antinuclear antibody(ANA) patterns and specific autoantibodies in antinuclear antibodies(ANAs).Methods Serum samples from 2 500 patients with suspected or diagnosed autoimmune rheumatic diseases(ARD) were subjected for ANA testing with indirect immunofluorescence(IIF),in which 826 patients were further processed line immunoassay(LIA) for ANAs.Results Among the analyzed samples(n=2 500),1 300 were positive for ANA.Among the samples submitted both for ANA-IIF and ANAs-LIA testing(n=826),182 patients(22.03%) were observed ANA(+)/ ANAs(+),529 patients(64.04%) were observed ANA(-)/ ANAs(-),111 patients(13.43%) were observed ANA(+)/ ANAs(-) and only 4 patients(0.05%) were observed ANA(-)/ ANAs(+).Nuclear speckled(62.2%),cytoplasmic speckled(13.3%),homogenous(9.7%) and nucleolar(8.9%) pattern were common in 1 300 positive ANA-IIF findings.Anti-SSA/Ro52 was the most frequent antibody with a nuclear speckled pattern,AMA-M2 was the most frequent antibody with a cytoplasmic speckled pattern and anti-dsDNA was the most frequent antibody with a homogeneous pattern.ANAs-LIA frequency increased with ANA-IIF titer.The positive rate of ANA in patients aged from 21 to 40 years was higher than that in the other age groups at titer of ≥1∶800(P<0.01).Conclusion ANA-IIF is a good screening test.The combination of ANA-IIF, the titer and ANAs-LIA may be useful for the diagnosis and differential diagnosis of ARD.