摘要
目的探讨就诊人群中抗核抗体(ANA)、抗心肌抗体(HMA)、抗胃壁细胞抗体(PCA)、抗平滑肌抗体(SMA)、抗肝肾微粒体抗体(LKMA)、抗线粒体抗体(AMA)、抗线粒体抗体M2亚型(AMA-M2)等自身抗体的阳性分布趋势,及其在不同疾病中的分布与疾病诊断的价值。方法用间接免疫荧光法检测14 282份临床血清标本中ANA、HMA、PCA、SMA、LKMA和AMA,用酶联免疫吸附测定(ELISA)检测AMA-M2亚型;结合患者临床资料分析这些自身抗体在不同年龄、性别和疾病中的阳性分布趋势及临床应用价值。结果ANA、HMA、PCA、SMA、LKMA、AMA和AMA-M2在14 282例就诊人群的阳性率分别为:41．23％、0．19％、3．26％、10．25％、0．11％、11．90％和6．96％。女性中ANA、AMA和AMA-M2阳性率显著高于男性(P<0．01),人群中ANA、PCA、SMA、AMA和AMA- M2阳性率随年龄增加而升高(SMA为P<0．05,其余P<0．01)。在系统性硬皮病(SSc)和系统性红斑狼疮(SLE)ANA阳性率达94．6％和93．9％,自身免疫性肝炎(AIH)中SMA阳性率64．5％,原发性胆汁性肝硬化(PBC)中AMA和AMA-M2阳性率最高,分别为83．2％、70．2％,但其他疾病中也有5．4％～22．6％和1．8％～12．9％不等的阳性率。结论SLE、SSc、类风湿关节炎(RA)、干燥综合征(SS)和肌炎／皮肌炎(PM／DM)患者中的主要阳性抗体为ANA,AIH患者主要为ANA和SMA阳性, PBC患者主要为ANA、AMA和AMA-M2阳性。但是,同一种自身抗体可以出现在不同的自身免疫性疾病(AID),如AMA可出现在AIH、SS和PM／DM中;一种AID可同时出现多种自身抗体,如AIH患者可出现ANA、SMA、AMA和AMA-M2同时阳性。因此,在临床诊疗中应综合分析,重视抗体滴度在AID诊疗中的作用,以避免片面根据某种自身抗体阳性所致的误诊。
Objective To explore the positive distribution of the anti-nuclear antibodies （ANA）, anti-myocardial antibodies （HMA）, anti-parietal cell antibodies （PCA）, anti-smooth muscle antibodies （SMA） , anti-liver/kidney microsomal antibodies （ LKMA ） , anti-mitochondria antibodies （ AMA ） and AMA-M2 autoimmune markers in population, different diseases and their clinical significance. Methods The ANA, HMA, PCA, SMA, LKMA and AMA in 14 282 specimens were measured by indirect immunolluorescence assay. AMA-M2 was measured by ELISA. The positive distribution of these autoantibodies in population of different ages, sexes and diseases, were investigated. The value of the positive results in autoimmune disease diagnosis were evaluated by combine the clinical data. Results The positive rate of ANA, HMA, PCA, SMA, LKMA, AMA and AMA-M2 is 41.23%, 0. 19%, 3.26%, 10. 25%, 0. 11%, 11.90% and 6. 96% respectively. The positive rate of ANA, AMA and AMA-M2 is statistically higher in female than in male （P 〈0. 01 ）. As the population age increased, the positive rate of ANA, PCA, SMA, AMA and AMA-M2 is increased （ SMA： P 〈 0. 05, others： P 〈 0.01 ）. The positive rate of ANA is 94. 6% in SSc and 93.9% in SLE, SMA is64. 5% in AIH. AMA and AMA-M2 in PBC is maximal, 83.2% and 70. 2% respectively. AMA and AMA-M2 in other diseases are from 5.4% to 22. 6% and 1.8% to 12. 9% respectively. Conclusions Of the seven autoantibodies detected, the primary positive autoantibody in SLE, RA, SSc, SS and PM/DM is ANA. In AIH they are ANA and SMA and in PBC they are ANA, AMA and AMA-M2. As one autoantibody could be positive in different diseases, such as AMA could be positive in AIH, SS and PM/DM , different autoantibodise could be positive in one disease simultaneously,for example ANA, SMA, AMA and AMA-M2 can be positive in AIH simultaneously. To avoid false diagnoses, We should think over the distribution of all the different positive autoantibodies, and attach importance to the titer of autoantibodies in AID diagnosis.
出处
《中华检验医学杂志》
CAS
CSCD
北大核心
2006年第8期688-691,共4页
Chinese Journal of Laboratory Medicine
关键词
自身抗体
自身免疫疾病
Autoantibodies
Autoimmune diseases
作者简介
通讯作者：李永哲，电子信箱：yongzhelipumch@yahoo．com．cn
