间接免疫荧光法与线性免疫印迹法联合检测抗核抗体在系统性红斑狼疮诊断中的意义

目的分析以间接免疫荧光法(IIF)法筛查的抗核抗体谱(ANAs)、抗双链DNA(dsDNA)抗体结果与线性免疫印迹法(LIA)检测ANAs的结果,了解2种方法是否可以相互取代及其联合检测的意义。方法 230例临床送检样本同时采用2种方法检测ANAs、抗dsDNA抗体与ANAs特异性抗体,分析检测结果的相互关系并寻找对临床有价值的检测方法。结果 2种方法检测结果总体符合率为57.0%;IIF(-)/LIA(+)患者中最易漏检的抗体为抗SSA抗体、Ro52、Jo-1、线粒体(AMA)-M2抗体。IIF(+)/LIA(-)中系统性红斑狼疮(SLE)组与非自身免疫病(AID)组在各个滴度间比较,差异均有统计学意义。检测抗dsDNA抗体,绿蝇短膜虫抗原片(CL)-IIF法的特异性和敏感性都超过了LIA法。SLE患者单一检测IIF-ANA敏感性较高,而LIA-ANAs特异性较高。2种方法联合诊断,敏感性提高。结论无论单独使用哪种检测方法都可能出现漏检的情况。2种方法不能互相代替,需同步检查。CL-IIF法检测抗dsDNA抗体的结果较LIA法更理想。

Detection of antinuclear antibodies by indirect immunofluorescence method and linear western blotting method combined in the diagnosis of systemic lupus erythematosus

Objective To analyze the method of immunofluorescence （IIF） antinuclear antibody screening, anti dsDNA antibodies（dsDNA） results with western blotting method （LIA） detection antinuclear antibodies （ANAs） result, determine whether the two methods can replace each other and the meaning of joint detection. Methods In 230 cases of clinical inspection samples at the same time using two methods of detecting antinuclear antibodies , dsDNA antibodies and ANAs specificity, analysis the relationship of the test results and find the detection methods of clinical value. Results The testing results of two methods of total coincidence rate is 57.0%; IIF（-）/LIA（＋） in patients with the leakiness antibodies for anti SSA, Ro52, Jo-1, the AMA-M2 antibodies. IIF（＋）/LIA（-） in SLE group and comparison between the drop degree of the AID group, difference has statistical significance. To detect resistance dsDNA antibody , the CL-IIF method more than the LIA method in specificity and sensitivity. SLE patients with single detection IIF-ANA sensitivity is higher, and LIA-ANAs specificity is higher. Two methods of joint diagnosis, increased sensitivity. Conclusion No matter use which kinds of detection methods alone is likely to be a leak. Two methods can′t replace each other, should be synchronized. The CL-IIF test results of a LIA dsDNA antibodies method is more ideal.