抗SSA、SSB抗体的荧光特点和临床意义

目的评价SSA、SSB抗体的荧光特点和临床意义,并探索在进行临床抗核抗体（ANA）筛查的过程中,鉴定这些抗体的必要性。方法对所有送检标本进行ANA和可提取性核抗原（ENA）检测,选择SSA、SSB阳性标本进行实验室和临床分析。结果在4 978个送检样本中,259个样本抗SSA、SSB阳性,阳性样本分为SSA＋SSB-、SSA-SSB＋和SSA＋SSB＋三组。与SSA＋SSB-组和SSA-SSB＋组比较,SSA＋SSB＋组ANA阴性样本比例（0.5%）明显降低（P〈0.01）,而高滴度样本比例（53.5%）明显增高（P〈0.01）。SSA和（或）SSB阳性样本除呈现颗粒型荧光外,还出现各种荧光核型。SSA＋SSB＋组颗粒型荧光的比例明显高于SSA＋SSB-和SSA-SSB＋（P〈0.01）。与SSA＋SSB-组相比,SSA＋SSB＋组患有干燥综合征（SS）的比例明显增高,患有其他疾病的比例明显降低。SSA-SSB＋组共8例患者,所患疾病各不相同。结论临床上检测SSA、SSB抗体具有必要性,联合检测SSA和SSB抗体可以提高SS诊断特异性。

Fluorescence characteristics and clinical significance of anti-SSA and SSB antibodies

ObjectiveTo evaluate fluorescence characteristics and clinical significance of anti-SSA and SSB antibodies and to explore whether identification of these antibodies was necessary in sera for ANA testing.Methods Serum ANA and ENA were detected for all the samples submitted to this laboratory.SSA and SSB positive samples were further analyzed.Results Of 4 978 consecutive samples submitted to the laboratory,259 with anti-SSA or SSB reactivity were analyzed and divided into three groups,SSA＋SSB-,SSA-SSB＋ and SSA＋SSB＋ groups.Compared with SSA＋SSB-group and SSA-SSB＋ group,the proportion（0.5%） of negative specimens was significantly decreased in SSA＋SSB＋ group（P0.01）,and the proportion（53.5%） of specimens with high titer was significantly increased（P0.01）.Besides speckled pattern,anti-SSA and（or） SSB antibody-positive samples presented various patterns on HEp-2 cells.However,SSA＋SSB＋ samples presented speckled pattern,significantly higher than SSA＋SSB-and SSA-SSB＋samples（P0.01）.Compared with SSA＋SSB-group,the prevalence of SS was significantly increased,and the prevalence of other diseases was significantly decreased in SSA＋SSB＋ group.However,each of 8 SSA-SSB＋ patients had unique disease.Conclusion The identification of anti-SSA and SSB antibodies is necessary.The specificity of anti-SSA antibody for SS could be improved,when combined with anti-SSB antibody.