自身免疫病中多种自身抗体的检测及分析

目的：通过对自身免疫病患者常用自身抗体的综合检测、分析，评价其在自身免疫病中的意义及价值。方法：选取临床上已确诊为自身免疫病患者216例作为疾病组（其中SLE患者102例，RA患者54例，MCTD患者18例，SS患者16例，PSS患者16，PM／DM患者10例），健康体检者30例作为对照组，抽取血液，分离血清，分别采用间接免疫荧光法、欧蒙免疫印迹法和ELISA法检测ANA、抗ds—DNA、ENA多肽谱、RF。结果：6种自身免疫性疾病中，RF的阳性检出率以类风湿性关节炎（RA）患者为最高（74．2％），干燥综合症（SS）患者次之（62．5％），而多发性皮肌炎（PM／DM）患者中未检出；ANA在6种自身免疫病患者中均有较高的阳性检出率，以系统性红斑狼疮（SLE）患者为最高（94．1％），混合性结缔组织病（MCTD）患者次之（88．9％），RA患者最低（33．3％）；抗ds—DNA则只在2种自身免疫病患者中检出，其中SLE患者阳性检出率最高（80．4％），而RA患者较低（3．7％）；6种自身免疫病患者中，ENA多肽谱的各种抗体的检出率差别较大，其中，抗SSA／R0均有检出，但阳性率不高（均低于40．0％），而抗-Histones只在SLE患者中有检出，抗scl70只在系统性硬皮病（PSS）患者中有检出，抗J0-1则只在PM／DM患者中有检出，但抗U1-snRNP则在MCTD患者中检出率较高（88．9％），抗-Centromere均无检出。结论：自身免疫病患者同时检测多种自身抗体有助于疾病的特异性诊断和筛查。

Detection and analysis of multiple autoantibodies in patients with autoimmune disease

Objective:To evaluate the significance of multiple autoantibody detection and analysis in the process of diagnosing and screening autoimmune diseases. Methods: 216 cases of autoimmune diseases were compared with 30 health volunteers. 102 out of these cases are SLE, 54 are RA, 18 are MCTD, 16 are SS, 16 are PSS and 10 are PM/DM, Autoantibody including ANA, anti-ds-DNA, ENA antibodies and RF were detected. Results: Among six kinds of autoimmune diseases mentioned above, RA has the highest positive rate of RF (74.2%) followed by SS (62.5%). On the contrary, in PM/DM, RF was detected as negative. SLE has the highest positive rate of ANA (94.1%) followed by MCTD (88.9%) and RA (33.3%). Anti-ds-DNA was only detected in SLE and RA with a positive rate of 80.4% and 3.7%, respectively. The positive rates of ENA antibodies in autoimmune diseases are obvious different among each other. Conclusion: Detection of multiple autoantibodies is a useful way of diagnosis and screening autoimmune diseases.