CAJ | 학술논문

目的：探讨检测抗核抗体（ANA）核型与抗可提取性核抗原(ENA)抗体及抗双链DNA（ds-DNA）抗体之间的相关性，提高对自身免疫性疾病(AID）的诊断及鉴别诊断参考价值。方法资料来源门诊及住院的AID病例血清标本进行检测，ANA检测采用间接免疫荧光法（IIF），抗ENA抗体检测采用欧蒙斑点法（抗nRNP/Sm、Sm、SSA/Ro、SSB/Lo、Scl-70和Jo-1）六项抗体及抗(ds-DNA)抗体采用ELISA法检测。结果在98例ANA阳性病例血清标本中核型分布为：细胞核均质型(36.74%)，细胞核颗粒型(41.84%)，细胞核仁型(11.22%)，细胞核膜型(1.02%)，细胞核着丝点型(1.02%)；重叠核型中细胞核均质型/细胞核颗粒型(2.04%)，细胞核均质型/细胞浆颗粒型（6.12%）等。98例ANA与ENA同时阳性血清标本中42例抗双链DNA抗体阳性(42.86%)。36例均质型阳性样本中抗SSA/Ro抗体(24.48%)，抗SSB/Lo抗体(6.12%)，抗nRNP/Sm抗体(6.12%)。41例细胞核颗粒型阳性样本抗nRNP/Sm抗体(19.39%)，SSA/Ro抗体(15.31%)，抗SSB/Lo抗体(6.12%)。ANA阳性可出现一种或多种自身抗体。结论 ANA常见核型有：细胞核颗粒型，细胞核均质型及细胞核仁型。ANA均质型核型检出的抗ds-DNA抗体为主，且抗ds-DNA抗体含量与荧光强度成正比。ANA核型与抗ENA抗体二者之间有一定的相对应性。ANA及核型、抗ENA抗体和抗ds-DNA抗体的联合检测可明确诊断AID，而且利于判断患者血清中各种自身抗体与临床表现的关系。
목적：탐토검측항핵항체（ANA）핵형여항가제취성핵항원(ENA)항체급항쌍련DNA（ds-DNA）항체지간적상관성，제고대자신면역성질병(AID）적진단급감별진단삼고개치。방법자료래원문진급주원적AID병례혈청표본진행검측，ANA검측채용간접면역형광법（IIF），항ENA항체검측채용구몽반점법（항nRNP/Sm、Sm、SSA/Ro、SSB/Lo、Scl-70화Jo-1）륙항항체급항(ds-DNA)항체채용ELISA법검측。결과재98례ANA양성병례혈청표본중핵형분포위：세포핵균질형(36.74%)，세포핵과립형(41.84%)，세포핵인형(11.22%)，세포핵막형(1.02%)，세포핵착사점형(1.02%)；중첩핵형중세포핵균질형/세포핵과립형(2.04%)，세포핵균질형/세포장과립형（6.12%）등。98례ANA여ENA동시양성혈청표본중42례항쌍련DNA항체양성(42.86%)。36례균질형양성양본중항SSA/Ro항체(24.48%)，항SSB/Lo항체(6.12%)，항nRNP/Sm항체(6.12%)。41례세포핵과립형양성양본항nRNP/Sm항체(19.39%)，SSA/Ro항체(15.31%)，항SSB/Lo항체(6.12%)。ANA양성가출현일충혹다충자신항체。결론 ANA상견핵형유：세포핵과립형，세포핵균질형급세포핵인형。ANA균질형핵형검출적항ds-DNA항체위주，차항ds-DNA항체함량여형광강도성정비。ANA핵형여항ENA항체이자지간유일정적상대응성。ANA급핵형、항ENA항체화항ds-DNA항체적연합검측가명학진단AID，이차리우판단환자혈청중각충자신항체여림상표현적관계。
Objective To investigate the association among ANA patterns, anti-ENA antibody and anti-dsDNA antibodies in autoimmune diseases, and the reference signiifcance of detecting these antibodies on the diagnosis and differential diagnosis of autoimmune diseases. Methods Serum samples from 98 pateints with autoimmune disorder were collected. ANA, anti-ENA and anti-dsDNA antibodies were detected using IIF, immuno-dot assay and ELISA. Results The distribution of different ANA nuclear types in the 98 samples was:pattern homogeneous (36.74%);pattern nucleoplasm granular (41.84%);pattern nucleolar (11.22%);pattern nuclear membrane (1.02%);pattern centromere (1.02%);pattern homogeneous/nucleoplasm granular (2.04%)and pattern homogeneous/cytoplasm granular (6.12%). These patterns may occur separately, also could appear at the same sample. Among these 98 samples with both ANA and anti-ENA positive, 42 cases were anti-dsDNA antibodies positive (42.86%). In the 36 patients with ANA-homogeneous, 24 cases were anti-SSA/Ro antibody positive, 6 cases were anti-SSB/La antibody positive, and 6 cases were nRNP/Sm antibody positive. While in the 41 ANA-nucleoplasm granular samples, the positive rates of SSARo, SSB/La and nRNP/Sm antibodies were 15.31%, 6.12%and 19.39%. One or several kinds of ENA antibodies could appear in patients with positive ANA and anti-dsDNA antibodies. Conclusion The familiar nuclear types of ANA include pattern nucleoplasm granular, pattern homogeneous and pattern nucleolar. They occur individually or concurrently, which was correlated with the appearance of anti-ENA and anti-dsDNA antibodies. Combined detection of ANA, ENA and dsDNA antibodies has higher speciifcity, sensibility and accuracy in the diagnosis of autoimmune diseases, and is better in describing the correlation of the auto-antibodies appeared in patients and his clinical manifestation, thus provide valuable reference index to the diagnosis, differential diagnosis and therapy of AID.