中华临床免疫和变态反应杂志2011，Vol.5Issue(3)：179-185,7.
间接免疫荧光法筛查抗核抗体与特异性抗体检测的相互关系
Relationship between Anti-nuclear Antibodies and the Detection of Specific Anti-nuclear Antibodies
摘要
Abstract
Objective To analyze the correlation between the antin-uclear antibody (ANA) results of large samples by indirect immunofluorescence (IIF) screening and specific anti-nuclear antibodies test and study the clinical significance of them and clarify whether they could replace each other in clinical practice.Methods 2 026 cases of consecutive clinical samples for ANA testing were tested by IIP with Hep-2 and line immunoassay (LIA) for the detection of specific ANA antibodies. All the samples were divided into autoimmune diseases ( AID) group, suspected AID group and non-AID group. The relationship between different test results and their clinical significance were analyzed. Results Of the 2 026 cases of specimens, 882 cases (43.53%) were IIF-ANAVLIA-ANAs+ , 266 cases (13. 13%) were IIF-ANAV LIA-ANAs ~ , 507 cases (25.02%) were IIF-ANA" /LIA-ANAs" and 206 cases (10. 17%) were IIF-ANA ~ /LIA-ANAs+. The overall compliance rate of IIF-ANA and LIA-ANA was 68. 56% , the consistency rate was moderate (K=0. All, P <0. 01), and there was significant difference between the results of IIF-ANA and UA-ANA {x2 = 416.21, P < 0.01). The positive rates of anti-Ro-52, anti-SS-A (Sjogren' s syndrome antigen A) , anti-dsDNA (double-stranded DNA) , anti-AMA-M2 (Anti-mitochondrial antibody M2) , anti-Sm (Smith antigen), anti-SS-B (Sjogren's syndrome antigen B), anti-nRNP/Sm (nuclear ribonucleoprotein/Smith antigen) and anti-Jo-1 (Jo-1 antigen) antibodies ranged from 6. 00% to 34.94% in the IIF-ANA"/LIA-ANAs+/1 group. Of the 312 cases of this group, 37. 18% patients (116 cases) were diagnosed as AID, higher than the non-AID group (22. 11 % ) (x2 = 16.97, P < 0. 01). Of the 325 cases of IIF-ANA+ /LIA-ANAs '' * group, 48. 0% of patients (156 cases ) were diagnosed as AID, higher than the non-AID group (22. 15% ) , and the proportion of patients with AID was higher than non-AID in each group of patients with IIF-ANA liter 1:80, 1:160-1 =320 and 2* 1:640 (x2 = 26.96, 7. 89, 19. 42, P < 0.01). Conclusions It has a tendency to miss some ANAs specific antibodies which has important clinical significance when ANA was screened only by IIF, whereas the detection of ANA specific antibodies is very limited, it is also very easy to lead to false negative in patients with autoimmune diseases. The screening of ANA by IIF and the detection of ANA specific antibodies by LIA could not replace each other in clinical practice. In order to avoid misdiagnosis of patients with autoimmune diseases, it is recommend to screen ANA by IIF and detect ANA specific antibodies simultaneously when the ANA test is needed to excluded the presence of autoimmune diseases.关键词
间接免疫荧光法/抗核抗体/免疫印迹法/敏感性/特异性Key words
indirect immunoiluorescence/ anti-nuclear antibody/ line immunoassay/ sensitivity/ specificity分类
医药卫生引用本文复制引用
胡朝军,李俊,张道强,张蜀澜,李丽君,董晓娟,张奉春,李永哲..间接免疫荧光法筛查抗核抗体与特异性抗体检测的相互关系[J].中华临床免疫和变态反应杂志,2011,5(3):179-185,7.基金项目
国家自然科学基金(30640084、30872331、81072486),国家十一五科技支撑计划(2008BAI59B02、2008BAI59B03),北京协和医院青年基金(I101430),威海市科技发展计划(2008093-8) （30640084、30872331、81072486）
