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1、分子诊断与治疗杂志2009年9月第1卷第3期JMolDiagnTher,September2009,Vol.1No.3·175··论著·979例自身免疫性疾病抗核抗体与抗ENA抗体联合检测的结果分析李霞梅冰王昌富★[摘要]目的回顾本实验室开展抗核抗体(antinuclearantibody,ANA)与抗可提取性核抗原(extractablenuclearantigens,ENA)抗体联合检测的情况,分析两者之间的相关性,并探讨联合检测在自身免疫性疾病中的应用价值。方法间接免疫荧光法检测ANA,生物芯片技术检测抗ENA(ds-DNA、Sm、SS-A/Ro、SS
2、-B/La、u1RNP、Scl-70、Jo-1、RibosomalP)抗体,并采用双盲法分析ANA阳性标本的荧光核型与抗ENA抗体的关系。结果979例临床标本中,ANA阳性的标本数为400例,阳性率为40.9%(400/979)。荧光核型主要是核颗粒型(249例)、核均质型(83例)、胞浆颗粒型(30例),同时对979例标本进行抗ENA抗体的检测,阳性标本数为199例,阳性率为20.3%(199/979),只有1例阳性出现在ANA阴性的标本中。在400例ANA阳性的标本中,抗ENA抗体的阳性率为49.5%(198/400),出现较多的阳性抗体是抗SS-A/R
3、o(133例)、抗RibP(78例)、抗u1RNP(70例)、抗ds-DNA(61例)、抗SS-B/La(40例)等抗体,主要与颗粒型荧光相关。而均质型ANA标本中,常见的抗ENA抗体是抗ds-DNA(37例)、抗SS-A/Ro(27例)、抗Jo-1(20例)、抗RibP(20例)等抗体。结论不同荧光核型的ANA与抗ENA抗体之间的关系有各自的特点。用间接荧光法筛查ANA,并联合抗ENA抗体谱进行分型,可以确定部分ANA靶抗原的类型,进一步扩展抗ENA抗体谱,才能准确确定靶抗原。[关键词]抗核抗体;抗ENA抗体;荧光核型Analysisoftheresult
4、sofantinuclearantibodyandanti-ENAantibodiesfor979patientsofautoimmunediseaseswithIIFandbiochiptechnologyLIXia,MEIBing,WANGChangfu★(DepartmentofClinicalLaboratory,AffiliatedJingzhouHospital,TongjiMedicalCollege,HuazhongUniversityofScienceandTechnology,Hubei,Jingzhou434020,China)[ABS
5、TRACT]ObjectiveToanalyzetherelationshipbetweenantinuclearantibody(ANA)andanti-extractablenuclearantigens(ENA)antibodiesinautoimmunediseases.MethodsANAandanti-ENA(ds-DNA、Sm、SS-A/Ro、SS-B/La、u1RNP、Scl-70、Jo-1、RibosomalP)antibodiesweredetectedbyindirectimmunofluorescence(IIF)andbiochip
6、technology,respectively.ResultsOfallthe979samples,400caseswerepositiveforANA,thepositiveratewas40.9%(400/979).Themajorityofpatternswerespeckledpattern(249cases,62.25%),homogeneouspattern(83cases,20.75%),andcytoplasmicgranularpattern(30cases,7.5%),respectively.Anti-ENAantibodieswere
7、detectedin979casessimultaneously,and199caseswerepositive.Thepositiveratewas20.3%(199/979),andonlyonecaseisnegativeforANA.Ofthe400cases,thepositiverateoftheanti-ENAantibodieswas49.5%.Themostfrequentlyoccurredantibodieswereanti-SS-A/Ro(133cases),anti-RibP(78cases),anti-u1RNP(70cases)
8、,anti-ds-DNA(61cases)andan