CAJ | 학술논문

目的：分析其中ANA表达阳性而抗ENA抗体表达阴性的样本的检验学特征及意义。方法对297例样本运用间接免疫荧光法检测ANA ，生物芯片技术检测抗ENA抗体，并采用双盲法分析ANA阳性标本的荧光核型。从已知的ANA阳性患者血清中筛选其ENA表达均为阴性的患者血清，比对其荧光核型并进行分析。结果297例临床标本中，ANA阳性标本数为74例，阳性率为24．9％（74／297）。其主要核型为核浆颗粒型（43例，58．1％）、胞浆颗粒型（9例，12．2％）、核浆点型（9例，12．2％）。在74例ANA阳性标本中，抗ENA抗体为阴性的标本数为13例，占阳性标本的17．6％。13例标本中有11例表现为核浆颗粒型，占84．6％；1例表现为胞浆颗粒型，占7．7％；1例表现为核浆点型，占7．7％。结论在ANA阳性同时抗ENA抗体表达为阴性的患者血清中，核浆颗粒型明显高于胞浆颗粒型与核浆点型在ANA标本中的阳性率，并且远大于核浆颗粒型在抗ENA抗体表现为阳性的ANA阳性标本中的比例（52．5％），差异有统计学意义（χ2＝5．018，P＜0．05）。在抗ENA抗体表现为阴性的ANA阳性标本中，荧光核型表现为核浆颗粒型有其自身特有的临床意义有助于筛选发现抗ENA抗体以外的新自身抗体。
목적：분석기중ANA표체양성이항ENA항체표체음성적양본적검험학특정급의의。방법대297례양본운용간접면역형광법검측ANA ，생물심편기술검측항ENA항체，병채용쌍맹법분석ANA양성표본적형광핵형。종이지적ANA양성환자혈청중사선기ENA표체균위음성적환자혈청，비대기형광핵형병진행분석。결과297례림상표본중，ANA양성표본수위74례，양성솔위24．9％（74／297）。기주요핵형위핵장과립형（43례，58．1％）、포장과립형（9례，12．2％）、핵장점형（9례，12．2％）。재74례ANA양성표본중，항ENA항체위음성적표본수위13례，점양성표본적17．6％。13례표본중유11례표현위핵장과립형，점84．6％；1례표현위포장과립형，점7．7％；1례표현위핵장점형，점7．7％。결론재ANA양성동시항ENA항체표체위음성적환자혈청중，핵장과립형명현고우포장과립형여핵장점형재ANA표본중적양성솔，병차원대우핵장과립형재항ENA항체표현위양성적ANA양성표본중적비례（52．5％），차이유통계학의의（χ2＝5．018，P＜0．05）。재항ENA항체표현위음성적ANA양성표본중，형광핵형표현위핵장과립형유기자신특유적림상의의유조우사선발현항ENA항체이외적신자신항체。
Objective To analyze the clinical features and significance of the samples which the expression of ANA is positive and the expression of anti‐ENA antibody is negative .Methods Detect ANA and anti‐ENA antibody of all the 297 samples by indi‐rect immunofluorescence method and biological chip technology ,repectively .And analyze the fluorescence karyotype of ANA posi‐tive specimens with double‐blind method .Screen the samples which anti‐ENA antibody express negative from ANA positive sam‐ples .Compare and analyze the fluorescent karyotype .Results Of all the 297 samples ,74 cases were positive for ANA ,the positive rate was 24 .9% (74/297) .The majority of patterns were speckled pattern (43 cases ,58 .1% ) ,cytoplasmic granular pattern (9 ca‐ses ,12 .2% ) ,and antibody to centromere antigen(9 cases ,12 .2% ) ,respectively .In 74 cases of ANA positive specimens ,ENA anti‐body the negative rate of ENA antibody is 17 .6% (13/74) .Of the 13 cases ,the most frequently occurred pattern was the speckled pattern(11 cases ,84 .6% ) ,the rate of cytoplasmic granular pattern and antibody to centromere antigen was 7 .7% (1/13) respec‐tively .Conclusion In the serum samples which express ANA positive and ENA antibody negative ,the rate of speckled pattern is significantly higher than the other patterns ,and far more than the rate of speckled pattern in the samples which express ENA anti‐body and ANA positive (52 .5% ) (chi‐square= 5 .018 ,P< 0 .05) ,with statistical significance .We consider the speckled pattern samples be in favour of discovering new antibodys of this kind of serum sample .