ANA联合dsDNA在自身免疫疾病中的相关性和敏感性分析
|
摘要
目的探讨ANA联合dsDNA在自身免疫疾病中的相关性和敏感性。方法选择2014年6月至2014年12月我院收治的自身免疫性疾病患者466例。采用间接免疫荧光法检测ANA、ELISA法检测dsDNA。观察ANA阳性患者ANA核型,SLE、MCTD等疾病患者ANA、dsDNA阳性率,以及不同疾病程度SLE患者血清ANA、dsDNA计分值。结果 184例ANA核型阳性患者中以核均质型构成比例最高,占33.15%,其次为胞浆型、核细颗粒型和核粗颗粒型,分别占20.11%、19.02%和16.30%。ANA阳性率从高到低分别是SLE、MCTD、PSS;dsDNA阳性率从高到低分别是SLE、MCTD。非活动期SLE患者ANA、dsDNA计分值明显低于中度活期组和重度活动期组,中度活动期组患者dsDNA计分值明显低于重度活动期组,差异具有统计学意义(P<0.05)。结论 ANA是诊断自身免疫疾病高度敏感的抗体,联合dsDNA可提高鉴别诊断准确性,为临床提供有价值的参考。
Objective To study the correlation and sensitivity of ANA combined with dsDNA in autoimmune diseases. Methods 466 patients with autoimmune diseases treated in our hospital from June 2014 to December 2014 were selected. ANA was detected by indirect immunofluorescence, dsDNA was detected by ELISA method. The karyotype of ANA positive patients, the positive rate of ANA and dsDNA of SLE patients and MCTD patients, the scoring value of ANA and dsDNA of patients with different degree of SLE were observed.Results The proportion of nuclear homogeneous type in 184 ANA positive patients was the highest, accounting for 33.15%, followed by the cytoplasm type(20.11%), nuclear fine particles type(19.02%) and coarse particles type(16.30%). The positive rate of ANA from high to low was SLE, MCTD, PSS; the positive rate of dsDNA from high to low was SLE, MCTD. The scoring value of ANA and dsDNA of SLE patients in inactive stage was lower than that of patients in moderate and severe stage, the scoring value of dsDNA of patients in moderate stage was lower than that of patients in severe stage(P <0.05). Conclusions ANA is highly sensitive to the diagnosis of autoimmune diseases. ANA combined with dsDNA can improve the accuracy of differential diagnosis, and provide a valuable reference for clinical diagnosis.
Objective To study the correlation and sensitivity of ANA combined with dsDNA in autoimmune diseases. Methods 466 patients with autoimmune diseases treated in our hospital from June 2014 to December 2014 were selected. ANA was detected by indirect immunofluorescence, dsDNA was detected by ELISA method. The karyotype of ANA positive patients, the positive rate of ANA and dsDNA of SLE patients and MCTD patients, the scoring value of ANA and dsDNA of patients with different degree of SLE were observed.Results The proportion of nuclear homogeneous type in 184 ANA positive patients was the highest, accounting for 33.15%, followed by the cytoplasm type(20.11%), nuclear fine particles type(19.02%) and coarse particles type(16.30%). The positive rate of ANA from high to low was SLE, MCTD, PSS; the positive rate of dsDNA from high to low was SLE, MCTD. The scoring value of ANA and dsDNA of SLE patients in inactive stage was lower than that of patients in moderate and severe stage, the scoring value of dsDNA of patients in moderate stage was lower than that of patients in severe stage(P <0.05). Conclusions ANA is highly sensitive to the diagnosis of autoimmune diseases. ANA combined with dsDNA can improve the accuracy of differential diagnosis, and provide a valuable reference for clinical diagnosis.
引文
[1]谌晓燕,陈艳,张银辉,等.ANA、抗ds DNA抗体和抗ENA抗体谱对系统性红斑狼疮的诊断价值[J].国际检验医学杂志,2014,35(9):1131-1133.
[2]彭赛蛟,陶锡东,王敏.不同自身抗体联合检测在系统性红斑狼疮中的诊断价值[J].中国免疫学杂志,2014,30(6):831-833,837.
[3]梁凯,蔡敏琪,易富,等.ENA抗体谱、ds DNA和ANA联合检测对SLE和RA的诊断意义[J].西南国防医药,2011,21(10):1101-1102.
[4]张晓梅,罗兴燕,连金泉,等.ANA、抗ds DNA、抗ENA抗体联合检测对系统性红斑狼疮患者的诊断及临床意义[J].南昌大学学报(医学版),2010,50(1):60-62.
[5]刘京平,林有坤,何钠.首诊系统性红斑狼疮住院患者ANA、抗dsDNA与病情活动的研究[J].中国皮肤性病学杂志,2008,22(1):26-28.
[6]周炳华,刘玉琴,普雄明,等.ANA、抗ds DNA、ANCA、抗ENA多肽抗体联合检测在SLE诊断中的价值[J].中国麻风皮肤病杂志,2005,21(4):280-281.
[7]孙善会,郑燕,张茂修,等.评价自身抗体联合检测在诊断自身免疫性疾病中的应用[J].中国医药指南,2013,11(36):20-22.
[8]Stamouli M,Skliris A,Reppa D,et al.Detection of antinucle ar antibodies(ANA),antibodies to double stranded DNA(anti-ds DNA)and antibodies to extractable nuclear anti gens(anti-ENA)in Greek patients[J].Clin Lab,2013,59(3-4):283-291.
[9]曾燕坤,吴杰.抗核抗体、抗核抗体谱及抗双链DNA抗体的联合检测系统性红斑狼疮的诊断价值[J].医学临床研究,2014,31(11):2081-2083.
[10]宁学玲,宁学洪,李国富.ANA、抗-ENA和抗-ds DNA抗体对SLE诊断的意义[J].中国热带医学,2011,11(3):381-382.
[11]郑霞,杜文平,刘宜升.免疫金银染色法检测SLE患者血清抗核抗体和抗双链DNA抗体的临床研究[J].徐州医学院学报,2002,22(6):500-502.
[12]Kim Y,Park Y,Lee EY,et al.Comparison of auto mated mul tiplexed bead-based ANA screening assay with ELISA for de tecting five com mon anti-extractable nuclear antigens and anti-ds DNA in sys temic rheumatic diseases[J].Clin Chim Acta,2012,413(1-2):308-311.
[2]彭赛蛟,陶锡东,王敏.不同自身抗体联合检测在系统性红斑狼疮中的诊断价值[J].中国免疫学杂志,2014,30(6):831-833,837.
[3]梁凯,蔡敏琪,易富,等.ENA抗体谱、ds DNA和ANA联合检测对SLE和RA的诊断意义[J].西南国防医药,2011,21(10):1101-1102.
[4]张晓梅,罗兴燕,连金泉,等.ANA、抗ds DNA、抗ENA抗体联合检测对系统性红斑狼疮患者的诊断及临床意义[J].南昌大学学报(医学版),2010,50(1):60-62.
[5]刘京平,林有坤,何钠.首诊系统性红斑狼疮住院患者ANA、抗dsDNA与病情活动的研究[J].中国皮肤性病学杂志,2008,22(1):26-28.
[6]周炳华,刘玉琴,普雄明,等.ANA、抗ds DNA、ANCA、抗ENA多肽抗体联合检测在SLE诊断中的价值[J].中国麻风皮肤病杂志,2005,21(4):280-281.
[7]孙善会,郑燕,张茂修,等.评价自身抗体联合检测在诊断自身免疫性疾病中的应用[J].中国医药指南,2013,11(36):20-22.
[8]Stamouli M,Skliris A,Reppa D,et al.Detection of antinucle ar antibodies(ANA),antibodies to double stranded DNA(anti-ds DNA)and antibodies to extractable nuclear anti gens(anti-ENA)in Greek patients[J].Clin Lab,2013,59(3-4):283-291.
[9]曾燕坤,吴杰.抗核抗体、抗核抗体谱及抗双链DNA抗体的联合检测系统性红斑狼疮的诊断价值[J].医学临床研究,2014,31(11):2081-2083.
[10]宁学玲,宁学洪,李国富.ANA、抗-ENA和抗-ds DNA抗体对SLE诊断的意义[J].中国热带医学,2011,11(3):381-382.
[11]郑霞,杜文平,刘宜升.免疫金银染色法检测SLE患者血清抗核抗体和抗双链DNA抗体的临床研究[J].徐州医学院学报,2002,22(6):500-502.
[12]Kim Y,Park Y,Lee EY,et al.Comparison of auto mated mul tiplexed bead-based ANA screening assay with ELISA for de tecting five com mon anti-extractable nuclear antigens and anti-ds DNA in sys temic rheumatic diseases[J].Clin Chim Acta,2012,413(1-2):308-311.