ANA、 ANCA、 HLA-B27、 anti-dsDNA在诊断免疫相关性葡萄膜炎中的价值

摘要

目的:探讨抗核抗体(ANA)、抗中性粒细胞胞质抗体(ANCA)、人类白细胞抗原B27(HLA-B27)、抗双链DNA抗体(anti-dsDNA)在诊断免疫相关性葡萄膜炎中的价值.方法:选取70例免疫相关性葡萄膜炎患者,收集患者的临床资料,检测患者血清中ANA、ANCA、anti-dsDNA和外周血淋巴细胞HLA-B27的表达水平.结果:男性患者年龄低于女性(t=2.845,P＜0.05);70例免疫相关性葡萄膜炎患者中,脊柱关节炎、原发性系统性血管炎、系统性红斑狼疮、原发性干燥综合征、类风湿性关节炎及幼年性特发性关节炎分别有42、12、6、5、4、1例,男女之间其中脊柱关节炎和系统性红斑狼疮比例差异有统计学意义(P=0.019、0.008).ANA阳性率为16％(11/70),ANCA阳性率为10％ (7/70),HLA-B27阳性率为59％ (41/70),anti-dsDNA阳性率为6％ (4/70);其中,男性的ANA、ANCA、anti-dsDNA阳性率均低于女性(P＜0.05),男性HLA-B27阳性率高于女性(x2=4.427,P＜0.05),差异均具有统计学意义.70例免疫相关性葡萄膜炎发病部位主要是前葡萄膜(49％)和全葡萄膜(46％).ANA主要在系统性红斑狼疮(83％)和原发性干燥综合征(60％)中表达;ANCA在免疫相关性葡萄膜炎中均有表达(除外脊柱关节炎和幼年性特发性关节炎);HLA-B27主要在脊柱关节炎(93％)中表达;anti-dsDNA主要在系统性红斑狼疮(67％)和类风湿性关节炎(25％)中表达.结论:ANA、ANCA、HLA-B27、anti-ds DNA的阳性率在不同免疫相关性葡萄膜炎的表现类型具有差异,对于免疫相关性葡萄膜炎的分类具有一定的辅助诊断作用.%AIM:To investigate the value of ANA,ANCA,HLA-B27,anti-dsDNA in the diagnosis of immune-related uveitis.METHODS:Totally 70 patients with immune-related uveitis were selected and the clinical data were collected.The levels of ANA,ANCA,anti-dsDNA in serum and HLA-B27 in peripheral blood lymphocytes were measured.RESULTS:Male patients were younger than femle patients (t=2.845,P＜0.05);there were 42 cases,12cases,6 cases,5 cases,4 cases,1 case,repectively in spondyloarthritis,primary systemic vasculitis,systemic lupus erythematosus,primary Sjogren's syndrome,rheumatoid arthritis and juvenile idiopathic arthritis among the 70 patients with immune-related uveitis.The proportion of spondylitis and systemic lupus erythematosus between men and women had significant difference (P=0.019,0.008).The ANA positive rate was 16％ (11/70),the positive rate of ANCA was 10％ (7/70),the positive rate of HLA-B27 was 59％ (41/70),the positive rate of anti-dsDNA was 6％ (4/70).Among the cases,in male ANA,ANCA,anti-dsDNA positive rate was lower than in women (P＜0.05).The positive rate of HLA-B27 in male was higher than that in female,the difference was significant (x2 =4.427,P＜0.05).The main site of the disease in 70 cases of immune-related uveitis were the anterior uvea (49％) and the entire uvea (46％).ANA was mainly expressed in systemic lupus erythematosus (83％) and primary Sjogren's syndrome (60％);ANCA was expressed in immune-related uveitis (except for spondyloarthritis and juvenile idiopathic arthritis);HLA-B27 was predominantly expressed in spondylarthritis (93％);anti-dsDNA was mainly expressed in systemic lupus erythematosus (67％) and rheumatoid arthritis (25％).CONCLUSION:The positive rates of ANA,ANCA,HLA-B27 and anti-dsDNA are different in different immunological-related uveitis,which has a certain diagnostic effect on the classification of immune-related uveitis.