CAJ | 학술논문

目的调查2012年我国自身抗体检测现状并与近十年结果进行比较,为进一步规范自身抗体检测提供依据.方法以自报名和选择相结合的方法在全国范围内确定参与单位,质量控制共6项、15份标本,包括ANA、抗dsDNA抗体、抗ENA抗体、抗线粒体抗体(AMA)、抗平滑肌抗体(ASMA)和抗CCP抗体.标本发放及结果分析采取双育操作.结果共148家医院/科室参加,分布于全国27个省市,采用多种免疫学方法进行检测.质控结果提示,ANA、AMA、ASMA、抗CCP抗体正确率高,分别是97.3％、96.1％、92.1％和97.4％.抗dsDNA抗体、抗ENA抗体正确率较低,分别为81.9％和77.2％.在抗ENA抗体谱中,抗RNP和抗Scl-70的正确率最低,分别是90.9％和80.3％.比较近10年的质控结果,自2009年以后,抗SSA抗体、抗SSB抗体、抗Sm抗体正确率保持稳定高水平,抗RNP及抗Scl-70准确率有所下降.检测方法方面,ANA、抗dsDNA抗体、AMA、ASMA采用的主要检测方法仍为间接免疫荧光法,抗ENA抗体为免疫印迹法,抗CCP抗体为ELISA法.结论 10年来自身抗体检测的主要方法无明显变化,总体正确率逐渐升高,但不同方法检测的正确率差异较大.
목적 조사2012년아국자신항체검측현상병여근십년결과진행비교,위진일보규범자신항체검측제공의거.방법 이자보명화선택상결합적방법재전국범위내학정삼여단위,질량공제공6항、15빈표본,포괄ANA、항dsDNA항체、항ENA항체、항선립체항체(AMA)、항평활기항체(ASMA)화항CCP항체.표본발방급결과분석채취쌍육조작.결과 공148가의원/과실삼가,분포우전국27개성시,채용다충면역학방법진행검측.질공결과제시,ANA、AMA、ASMA、항CCP항체정학솔고,분별시97.3％、96.1％、92.1％화97.4％.항dsDNA항체、항ENA항체정학솔교저,분별위81.9％화77.2％.재항ENA항체보중,항RNP화항Scl-70적정학솔최저,분별시90.9％화80.3％.비교근10년적질공결과,자2009년이후,항SSA항체、항SSB항체、항Sm항체정학솔보지은정고수평,항RNP급항Scl-70준학솔유소하강.검측방법방면,ANA、항dsDNA항체、AMA、ASMA채용적주요검측방법잉위간접면역형광법,항ENA항체위면역인적법,항CCP항체위ELISA법.결론 10년래자신항체검측적주요방법무명현변화,총체정학솔축점승고,단불동방법검측적정학솔차이교대.
Objective To investigate the current national situation of autoantibody test in order to improve the quality of autoantibodies test.Methods Hospitals or departments in the whole country participated voluntarily or on invitation.Fifteen samples in total were distributed double-blindly,and autoantibodies including anti-nuclear antibody (ANA),anti-double-stranded DNA (anti-dsDNA) antibody,anti-extractable nuclear antigens (anti-ENA),anti-citrulline antibody (anti-CCP),anti-mitochondria antibody (AMA) and anti-smooth muscle antibody (ASMA) were tested in 6 samples.The samples were used for AMA and ASMA tests.Results A total of 148 hospitals or departments participated and multiple testing methods were adopted.The accurate rate of ANA(97.3％),AMA (96.1％),ASMA (92.1％) and anti-CCP (97.4％) were higher than that of anti-dsDNA (81.9％) and anti-ENA (77.2％).Anti-RNP and anti-Scl70 in anti-ENAs had the lower accurate rate,90.9％ and 80.3％ respectively.Taking data of the past 10 years together,the accuracy of antiSSA,anti-SSB,anti-Sm had been stable since 2009,while that of anti-RNP and anti-Scl70 decreased slightly.For methodology,indirect immunofluorescence was mainly adopted in the testing of ANA,anti-dsDNA,AMA and ASMA,immunoblotting was mainly adopted in anti-ENA detection and enzyme linked immunosorbent serologic assay was used for anti-CCP test.Conclusion No major variation of primary testing method is found in recent 10 years.Although diverged greatly among different methods,the accuracy of antibody detection has improved year by year.