CAJ | 학술논문

目的：探讨抗核抗体（ANA）常见类型在四川地区自身免疫性疾病（AID）患者中的分布趋势及临床价值。方法采用免疫印迹法对2011年1月至2013年9月4188份疑似AID患者的临床标本进行ANA常见15种类型（抗NRNP、抗SM、抗SS-A、抗RO-52、抗SS-B、抗SCL-70、抗PM-SCL、抗JO-1、抗CENP、抗PCNA、抗ds-DNA、抗组蛋白、抗核小体、抗核糖体P蛋白及抗AMAM2）的检测，统计其分布情况，并对性别、年龄及季节进行分组，采用χ2检验进行统计学分析。结果（1）在4188份标本中，ANA阳性率为28.8%，AID阳性率为7.2%。在确诊的303例AID患者中，干燥综合征（SS）患者抗SS-A阳性率（75.4%）最高，依次为抗RO-52（61.5%）及抗SS-B（20.5%）；系统性红斑狼疮（SLE）患者抗SS-A阳性率（76.8%）最高，依次为抗 RO-52（64.2%）及抗 ds-DNA （41.1%）；混合性结缔组织（MCTD）患者抗 RO-52阳性率（42.5%）最高，其次为抗SS-A（41.1%）及抗NRNP（26.0%）；类风湿性关节炎（RA）患者抗SM阳性率（65.4%）最高，其次为抗SS-A（38.5%）。SS是四川地区最常见的AID，依次为SLE、MCTD及RA等。（2）在4188例疑似AID患者中，女性AID阳性率（11.0%）显著高于男性（1.5%），差异有统计学意义（χ2=136.44，P<0.05）；年龄组中18~45岁组阳性率最高（8.4%），<18岁组最低（2.1%），差异有统计学意义（χ2=8.92，P<0.05）；季度组中第4季度阳性率最高（8.6%），第1季度最低（6.2%），差异有统计学意义（χ2=3.47，P<0.05）。结论四川地区AID患者ANA常见类型分布可能与年龄、季节及性别相关，这在AID的诊断方面有重要价值。
목적：탐토항핵항체（ANA）상견류형재사천지구자신면역성질병（AID）환자중적분포추세급림상개치。방법채용면역인적법대2011년1월지2013년9월4188빈의사AID환자적림상표본진행ANA상견15충류형（항NRNP、항SM、항SS-A、항RO-52、항SS-B、항SCL-70、항PM-SCL、항JO-1、항CENP、항PCNA、항ds-DNA、항조단백、항핵소체、항핵당체P단백급항AMAM2）적검측，통계기분포정황，병대성별、년령급계절진행분조，채용χ2검험진행통계학분석。결과（1）재4188빈표본중，ANA양성솔위28.8%，AID양성솔위7.2%。재학진적303례AID환자중，간조종합정（SS）환자항SS-A양성솔（75.4%）최고，의차위항RO-52（61.5%）급항SS-B（20.5%）；계통성홍반랑창（SLE）환자항SS-A양성솔（76.8%）최고，의차위항 RO-52（64.2%）급항 ds-DNA （41.1%）；혼합성결체조직（MCTD）환자항 RO-52양성솔（42.5%）최고，기차위항SS-A（41.1%）급항NRNP（26.0%）；류풍습성관절염（RA）환자항SM양성솔（65.4%）최고，기차위항SS-A（38.5%）。SS시사천지구최상견적AID，의차위SLE、MCTD급RA등。（2）재4188례의사AID환자중，녀성AID양성솔（11.0%）현저고우남성（1.5%），차이유통계학의의（χ2=136.44，P<0.05）；년령조중18~45세조양성솔최고（8.4%），<18세조최저（2.1%），차이유통계학의의（χ2=8.92，P<0.05）；계도조중제4계도양성솔최고（8.6%），제1계도최저（6.2%），차이유통계학의의（χ2=3.47，P<0.05）。결론사천지구AID환자ANA상견류형분포가능여년령、계절급성별상관，저재AID적진단방면유중요개치。
Objective To explore the distribution trend and clinical value of antinuclear antibody (ANA) in patients with autoimmune diseases ( AID ) in Sichuan region . Methods Immunoblotting test was employed among 4 188 specimens with suspected AID from January 2011 to September 2013 to determine the 15 common types of ANA (anti-NRNP,anti-SM,anti-SS-A, anti-RO-52,anti-SS-B,anti-SCL-70,anti-PM-SCL,anti-JO-1,anti-CENP,anti-PCNA,anti-ds-DNA,anti-histone,anti-nucleosome, antiribo-somal P protein and anti-AMAM2),to summarize the statistical distribution and divide according to the gender ,age and season. The results were analyzed statistically byχ2 test. Results (1)In 4188 specimens,the positive rates of ANA and AID were 28.8%and 7.2%respectively. In 303 patients with confirmed AID ,the positive rate of anti-SS-A of patients with sicca syndrome (SS) was highest(75.4%),followed by anti-RO-52(61.5%) and anti-SS-B(20.5%);the positive rate of anti-SS-A of patients with systemic lupus erythematosus(SLE) was the highest (76.8%),followed by anti-RO-52(64.2%) and anti-ds-DNA (41.1%);the positive rate of anti-RO-52 of patients with mixed connective tissue disease(MCTD) was the highest(42.5%),followed by anti-SS-A (41.1%) and anti-NRNP(26.0%);the positive rate of anti-SM of patients with rheumatoid arthritis(RA) was the highest (65.4%), followed by anti-SS-A(38.5%). SS was the most common AID in Sichuan region,followed by SLE,MCTD and RA. (2) In 4 188 patients with suspected AID,the positive rate of AID of female(11.0%) was obviously higher than that of the male(1.5%) with statistically significant difference(χ2=136.44,P<0.05);the positive rate of the patients with the age from 18 to 15 years old was the highest(8.4%),while the patients less than 18 years old were the lowest(2.1%),and the difference had statistical significance (χ2=8.92,P<0.05);the fourth quarter had the highest positive rate(8.6%),while the first quarter had the lowest(6.2%),and the difference was statistically significant(χ2=3.47,P<0.05). Conclusions The common distribution of ANA of AID patients in Sichuan region might be related with age and season ,which has important value for AID diagnosis.