间接免疫荧光法与线性免疫印迹法对自身抗体检测结果分析

摘要

目的：探讨自身特异性抗体筛查试验间接免疫荧光法(IIF)与确认试验线性免疫印迹法(LIA)检测结果的相关性。方法：用 IIF 法作为抗核抗体(ANA)的筛查试验,用 LIA 法作为抗核抗体谱(ANAs)特异性抗体的确认试验,对自身免疫性疾病组(AID)及非 AID 疾病对照组进行检测分析,并将检测结果分为四组：IIF-ANA+/LIA+组,IIF-ANA+/LIA-组,IIF-ANA-/LIA+组和 IIF-ANA-/LIA-组。结果：①在611例 AID 组中,IIF-ANA+/LIA+336例(55%),IIF-ANA+/LIA-116例(19%),IF-ANA-/LIA+55例(9%),IIF-ANA-/LIA-104例(17%)。②在100例非 AID 组中,IIF-ANA+/LIA+2例(2%),IIF-ANA+/LIA-7例(7%),IIF-ANA-/LIA+3例(3%),IIF-ANA-/LIA-88例(88%),总体符合率90%。AID 组与非 AID 组自身抗体的检测结果比较差异有统计学意义。③ IIF-ANA-/LIA+组中,以抗 SSA 抗体、抗 Ro-52抗体、抗 ds-DNA 抗体、抗组蛋白抗体、抗 Jo-1抗体为主要检测出的阳性自身抗体。AID 组 IIF-ANA+/LIA-中,ANA检测核型以均质型、斑点型为主,混合核型以均质斑点型为主,荧光检测滴度以1∶40~1∶320为主；非 AID 组 IIF-ANA+/LIA-中,核型以斑点型为主,荧光滴度以1∶40~1∶320为主。结论：AID 患者可能会出现 IIF-ANA 检测阳性而 LIA-ANAs 检测阴性或者 IIF-ANA 检测阴性而 LIA-ANAs 检测阳性,检查除了进行 IIF 筛查 ANA 外,还需进行自身抗体谱的特异性抗体确认实验。%Objective:To explore the correlation of the specific antibody results between screening test of IIF and validation test of LIA.Methods:IIF method as ANA screening test,using LIA method as the validation test of ANAs ,Analysis the group of AID and the disease control group of not AID,the test results can be divided into four groups:group IIF ANA + / LIA +,group IIF ANA + / LIA-,group IIF-ANA-/ LIA +,group IIF-ANA-/ LIA-.Results:①In 61 1 cases of AID groups:IIF ANA + / LIA + had 336 patients (55%),IIF ANA+ / LIA-had 1 1 6 patients (1 9%),IIF ANA-/ LIA + had 55 cases (9%),IIF ANA-/ LIA-had 104 patients (1 7%).②In 100 cases of the not AID group:IIF ANA + /LIA + had 2 cases (2%),IIF ANA + /LIA-had 7 cases (7%),IIF ANA-/ LIA + had 3 cases (3%),IIF ANA-/LIA-have 88 patients (88%),the overall coinci-dence rate was 90%.Two groups autoantibodies detection results had significant statistical significance difference .③In the IIF ANA-/LIA + group,there are anti SSA antibody,anti Ro-52 antibody,anti ds-DNA antibody,anti-histonesantibody,anti Jo-1 antibody as main detected positive autoantibodies.In the AID groups of IIF ANA + /LIA-,ANA detection karyotype was given priority to with homogeneous,spots,and mixed karyotype was given priority to with homogeneous spots type,and the fluorescence detection of antibody titer was given priority to with 1∶40~1∶320;In the not AID group IIF ANA +/LIA-,karyotype was given priority to with spot type,the fluo-rescence detection of antibody titer was given priority to with 1∶40~1∶320.Conclusion:In the clinical test of AID may appear the IIF test positive for the ANA and LIA-ANAs test negative or IIF-ANA test negative and LIA-AN-As test positive.So in the clinical test of AID,in addition to the IIF screening test,you also need to do the confirma-tion experiment of autoantibodies spectrum simultaneously,so as to avoid a misdiagnosis because ofthe single test.