抗中性粒细胞胞浆抗体在肾炎综合征中的检测及临床意义

目的 探讨抗中性粒细胞胞浆抗体（ANCA）及其靶抗原检测在肾炎综合征中的临床意义。方法 应用间接免疫荧光（IIF）检测100例肾炎综合征患者血清抗中性粒细胞胞浆抗体，对其阳性的29例用酶联免疫吸附试验（ELISA）检测靶抗原髓过氧化物酶（MPO）和蛋白酶3（PR3）。结果 ⅡF检测肾炎综合征ANCA阳性率为29％，其中胞浆型10％、核周型19％。急性型肾炎、狼疮性肾炎、紫癜性肾炎阳性率分别为56％、20％和15％。ELISA检测在急进性肾炎和紫癜性肾炎大多数识别靶抗原MPO，狼疮性肾炎ANCA不识别MPO或PR3。结论 ANCA在急性性肾炎和狼疮性肾炎中阳性率高，有重要诊断意义，对狼疮性肾炎活动及疗效判断也具有参考价值。

THE DETECTION AND ITS CLINICAL SIGNIFICANCE OF ANTI-NEUTROPIL CYTOPLASMIC ANTIBODIES IN PATIENTS WITH NEPHRITIC SYNDROME

Objective To explore the clinical significance of the detection of antineutrophil cytoplasmic antibodies (ANCA) and their target antigens in patients with nephritic syndrome.Methods Indirect immunofluorescence (IIF) was used to detect ANCA in 100 serum samples and ELISA was used to detect proteinase 3 (PR3) and myeloperoxidase (MPO) in 29 ANCA positive samples.Results 29% of the sera was found ANCA positive by IIF method, 10% of which were of cytoplasmic ANCA, 19% of peripheral nuclear ANCA. The positive rates of rapidly progressive glumerulonephritis,lupus nephritis and anaphylactic purpuric nephritis were 56% ,20% and 15% respectively.ELISA detection showed that most of ANCA in rapidly progressive glomerulonephritis and anaphylactic purpuric nephritis recognized MPO and ANCA in lupus nephritis failed to recognize MPO or PR3.Conclusion The high positive rates of ANCA in rapidly progressive glomerulonephritis and lupus nephritis have great dignostic significance and might also be correlated to lupus nephritic activities and the judgement of their curative effects