致密细斑点型抗核抗体在系统性自身免疫性风湿性疾病诊断中的意义

doi:10.3969/j.issn.1673-8640.2021.07.002

检验医学 ›› 2021, Vol. 36 ›› Issue (7): 691-695.DOI: 10.3969/j.issn.1673-8640.2021.07.002

致密细斑点型抗核抗体在系统性自身免疫性风湿性疾病诊断中的意义

杨可可, 吴俊渊, 曹兴建

南通市第一人民医院检验科,南通江苏 226001

收稿日期:2020-03-11 出版日期:2021-07-30 发布日期:2021-07-26
通讯作者: 曹兴建
作者简介:曹兴建,联系电话：0513-85061219。
杨可可,女,1989年生,硕士,主管技师,主要从事代谢与免疫学研究。
基金资助:
南通市卫生和计划生育委员会科研基金项目(wkzl2018003)

Role of anti-nuclear antibody-dense fine speckled pattern for diagnosing systemic autoimmune rheumatic disease

YANG Keke, WU Junyuan, CAO Xingjian

Department of Clinical Laboratory,the First People's Hospital of Nantong,Nantong 226001,Jiangsu,China

Received:2020-03-11 Online:2021-07-30 Published:2021-07-26
Contact: CAO Xingjian

摘要/Abstract

摘要：

目的探讨致密细斑点型抗核抗体在系统性自身免疫性风湿性疾病（SARD）诊断中的价值。方法选取1 683例疑似或确诊为SARD的患者,分别用间接免疫荧光法（IIF）检测抗核抗体,免疫印迹法检测自身抗体。对IIF阳性、免疫印迹法阴性和2种方法均阳性的样本进行抗核抗体核型分析。采用秩相关分析评价致密细斑点型抗核抗体滴度与SARD的相关性。结果 IIF检测抗核抗体的阳性率与免疫印迹法检测自身抗体的阳性率比较,差异无统计学意义（P=0.155）。在72例IIF阳性、免疫印迹法阴性样本中,核颗粒型、致密细斑点型、均质型和核仁型所占比例分别为44.44%、40.28%、12.50%、2.78%。致密细斑点型所占比例与核颗粒型比较、差异无统计学意义（P=0.701）;与均质型、核仁型比较,差异均有统计学意义（P=0.001、P<0.001）。致密细斑点型抗核抗体的荧光滴度与SARD无相关性（r=-0.300,P=0.667）。644例2种方法均阳性的样本中,无致密细斑点型抗核抗体阳性。结论致密细斑点型抗核抗体阳性或可用于排除SARD。

关键词: 致密细斑点型抗核抗体, 自身抗体, 系统性自身免疫性风湿性疾病

Abstract:

Objective To investigate the role of anti-nuclear antibody（ANA）-dense fine speckled pattern in the diagnosis of systemic autoimmune rheumatic disease（SARD）.Methods A total of 1 683 samples from suspected or diagnosed patients suffering from SARD were determined for ANA by indirect immunofluorescence（IIF） and anti-extractable nuclear antigen antibody（ENA） by immunoblotting test. The identifications of ANA type were performed on samples positive by IIF but negative by immunoblotting test and both positive by IIF and immunoblotting test. The correlation of ANA-dense fine speckled pattern and the occurrence of SARD was evaluated by rank correlation analysis. Results There was no statistical significance between the positive rates by IIF-ANA and immunoblotting test-ENA（P=0.155）. In 72 samples only positive by IIF,the common speckled pattern accounted for 44.44%,and dense fine speckled pattern accounted for 40.28% without statistical significance（P=0.701）. The homogeneous pattern（12.50%） and nucleolus pattern（2.78%） showed statistical significance with dense fine speckled pattern（P=0.001,P<0.001）. There was no correlation between dense fine speckled pattern and SARD（r=-0.300,P=0.667）. Dense fine speckled pattern appeared in none of the 644 samples both positive by IIF-ANA and immunoblotting test-ENA. Conclusions The positive ANA-dense fine speckled pattern may be applied in excluding SARD.

Key words: Anti-nuclear antibody-dense fine speckled pattern, Autoantibody, Systemic autoimmune rheumatic disease

中图分类号:

R446.1

杨可可, 吴俊渊, 曹兴建. 致密细斑点型抗核抗体在系统性自身免疫性风湿性疾病诊断中的意义[J]. 检验医学, 2021, 36(7): 691-695.

YANG Keke, WU Junyuan, CAO Xingjian. Role of anti-nuclear antibody-dense fine speckled pattern for diagnosing systemic autoimmune rheumatic disease[J]. Laboratory Medicine, 2021, 36(7): 691-695.

图/表 2

参考文献 13

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免疫印迹法	IIF		合计
免疫印迹法	+	-	合计
+	644	55	699
-	72	912	984
合计	716	967	1 683

免疫印迹法	IIF		合计
免疫印迹法	+	-	合计
+	644	55	699
-	72	912	984
合计	716	967	1 683

核型	自身抗体种类	例数	百分比/%
核颗粒型	抗nRNP抗体、抗Sm抗体、抗SS-A抗体、抗Ro52抗体、抗SS-B抗体	251	38.98
核均质型	抗Ro52抗体、抗Scl-70抗体、抗dsDNA抗体、AnuA、AHA	109	16.93
胞浆颗粒型	抗Ro52抗体、抗Jo-1抗体、ARPA、AMA-M2	142	22.05
着丝点型	抗CENP-B抗体	60	9.32
核点型		39	6.05
核膜型		13	2.01
核仁型	抗Ro52抗体、抗PM-Scl抗体	19	2.95
其他（溶酶体型、高尔基体型、胞浆纤维型、PCNA型）	抗Ro52抗体、抗PCNA抗体	11	1.71

核型	自身抗体种类	例数	百分比/%
核颗粒型	抗nRNP抗体、抗Sm抗体、抗SS-A抗体、抗Ro52抗体、抗SS-B抗体	251	38.98
核均质型	抗Ro52抗体、抗Scl-70抗体、抗dsDNA抗体、AnuA、AHA	109	16.93
胞浆颗粒型	抗Ro52抗体、抗Jo-1抗体、ARPA、AMA-M2	142	22.05
着丝点型	抗CENP-B抗体	60	9.32
核点型		39	6.05
核膜型		13	2.01
核仁型	抗Ro52抗体、抗PM-Scl抗体	19	2.95
其他（溶酶体型、高尔基体型、胞浆纤维型、PCNA型）	抗Ro52抗体、抗PCNA抗体	11	1.71

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致密细斑点型抗核抗体在系统性自身免疫性风湿性疾病诊断中的意义

Role of anti-nuclear antibody-dense fine speckled pattern for diagnosing systemic autoimmune rheumatic disease

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