[1]晁亚妮a,盖玉萍a,赵咏梅b,等.系统性红斑狼疮患者血清抗核抗体免疫荧光核型与特异性抗体谱的相关分析[J].现代检验医学杂志,2020,35(05):41-44,61.[doi:10.3969/j.issn.1671-7414.2020.05.011]
　CHAO Ya-nia,GAI Yu-pinga,ZHAO Yong-meib,et al.Analysis of Serum Antinuclear Antibody Fluorescence Patterns and Specific Antibodies Profile in Patients with Systemic Lupus Erythematosus[J].Journal of Modern Laboratory Medicine,2020,35(05):41-44,61.[doi:10.3969/j.issn.1671-7414.2020.05.011]
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系统性红斑狼疮患者血清抗核抗体免疫荧光核型与特异性抗体谱的相关分析()
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《现代检验医学杂志》[ISSN:/CN:]

卷:
第35卷
期数:
2020年05期
页码:
41-44,61
栏目:
论著
出版日期:
2020-11-01

文章信息/Info

Title:
Analysis of Serum Antinuclear Antibody Fluorescence Patterns and Specific Antibodies Profile in Patients with Systemic Lupus Erythematosus
文章编号:
1671-7414（2020）05-041-05
作者:
晁亚妮a; 盖玉萍a; 赵咏梅b; 何华月a; 白文栋a; 邹红云a
新疆军区总医院a. 检验科；b. 血液科，乌鲁木齐 830000
Author(s):
CHAO Ya-nia;  GAI Yu-pinga;  ZHAO Yong-meib;  HE Hua-yuea;  BAI Wen-donga;  ZOU Hong-yuna
a.Department of Clinical Laboratory; b. Department of Hematology, General Hospital of Xinjiang Military Command,Urumqi 830000, China
关键词:
系统性红斑狼疮; 抗核抗体; 抗核抗体谱
分类号:
R593.241；R392.11
DOI:
10.3969/j.issn.1671-7414.2020.05.011
文献标志码:
A
摘要:
目的　探讨系统性红斑狼疮 (systemic lupus erythematosus, SLE）患者血清抗核抗体 (antinuclear antibody, ANA) 免疫荧光核型与特异性抗体谱（antinuclear antibody profile, ANAs）之间的相关性。方法　回顾性调查和分析2015 年1 月~2018 年12 月263 例SLE 住院患者的ANA 及ANAs 实验结果。线性免疫印迹法（Line-blot immunoassay, LIA）检 测ANAs，间接免疫荧光法（indirect immunofluorescence, IIF）检测ANA，荧光显微镜下核对ANA 免疫荧光滴度和特 异性荧光核型。对荧光核型与特异性抗体谱结果进行统计分析。结果　① 263 例SLE 患者血清IIF-ANA 检测阳性率为 94.29 %，LIA-ANAs 检测阳性率为89.73 %，二者差异无统计学意义（χ2= 3.73，P> 0.05）；IIF-ANA 和LIA-ANAs 检 测结果的总体一致率为89.35 %，二种方法检测结果不一致，差异具有统计学意义（χ2= 263，P < 0.05），检测一致性 较差（Kappa = 0.281，P< 0.05）；② IIF-ANA 阳性病例中，随着ANA 滴度增加，LIA-ANAs 阳性率逐渐增高，不同 ANA 滴度组LIA-ANAs 阳性率差异具有统计学意义（χ2=22.93，P < 0.05）；③ IIF-ANA 阳性患者免疫荧光核型以核颗 粒型（68.54%）和核均质型（32.26 %）为主；核颗粒型多为ds-DNA 和RNP 抗体为主，核均质型多为ds-DNA 和核小 体抗体为主。结论　不同荧光核型ANA 与ANAs 抗体间具有一定相关性，IIF-ANA 筛查与 LIA-ANAs 特异性抗体确认 实验联合检测，有助于提高自身抗体阳性检出率，为SLE 的准确诊断和及时治疗提供有价值的参考依据。
Abstract:
Objective　To analyze the detection results of serum antinuclear antibodies (ANA) and specific antibodies profile (ANAs) in patients with SLE, as well as to assess the association between ANA fluorescence patterns and ANAs. Methods　The study enrolled 263 patients with SLE in the hospital from January 2015 to December 2018 . In all examinees, antinuclear antibody was tested by using indirect immunofluorescence (IIF) assay , and specific antibodies profile was detected by using the line-blot immunoassay (LIA). The characteristic fluorescence patterns were checked under fluorescence microscope. Results　① The results revealed that ANA was positive in 94.29% of the patients, ANAs in 89.73%, but there was no statistically significant difference between the two rate（s χ2 = 3.726, P > 0.05）. The coincidence rate of ANA and ANAs was 89.35 %, and there was a significant difference between the two assays (χ2=263, P < 0.05). The Kappa analysis revealed a less consistency of the two assays（Kappa = 0.281, P < 0.05）. ②With the increase of ANA titer, the positive rate of ANAs increased , and the difference between different ANA titer groups was statistically significant（χ2=22.93， P< 0.05）. ③ In IIF-ANA positive cases, 68.54% showed nuclear speckled pattern , 32.26 % showed nuclear homogeneous pattern. ds- DNA and RNP antibodies were frequently detected in the nuclear speckled pattern. ds-DNA and nucleosome(NUC) were detected more frequently in the nuclear homogeneous pattern. Conclusion　The combined detection of ANA and ANAs can help to improve the positive detection rate of autoantibodies and provide valuable reference for the accurate diagnosis and timely treatment of SLE.

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备注/Memo

备注/Memo:
基金项目：新疆维吾尔自治区自然科学基金面上项目（2016D01C394）。
作者简介：晁亚妮(1980-), 女，技师，主要从事医学检验工作， E-mail: 307905231@qq.com。
通讯作者：邹红云(1970-）, 女, 医学博士，副主任医师. 主要从事自身免疫实验诊断与发病机制研究，E-mail:yijiamin2000@163.com。
更新日期/Last Update: 2020-10-30