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目的:探讨抗核抗体(ANA)与抗可溶性抗原(ENA)抗体之间的关系,明确临床疾病的诊断。方法:对武汉市协和医院88例ANA间接免疫荧光法阴性与ENA免疫印迹法阳性模式的住院样本,收集临床资料,其中46例SSA阳性的样本,采用ELISA对特异性自身抗体进行测定,稀释比例设为1∶32和1∶10时采用IIF再次检测ANA。结果:在1 770例住院标本中,ANA IIF(-)LIA(+)模式在4种模式中占4.97%。LIA阳性抗体有抗SSA、抗组蛋白、抗nRNP等。IIF(-)LIA(+)实验组与IIF(-)LIA(-)对照组相比,2组在1∶32转阳率(41.3%和2.5%)、1∶10转阳率(56.5%和7.5%)之间差异均有统计学意义(均P<0.05),稀释度从1∶100降为1∶32及1∶10后,ANA的阳转率均有提高。结论:对于ANA IIF(-)LIA(+)检测模式,降低稀释度时可减少ANA的漏检,提高IIF与LIA的一致性,确保临床诊断的准确性。
Objective: To explore the relationship between antinuclear antibody (ANA) and anti-soluble antigen (ENA) antibody and to confirm the diagnosis of clinical disease. Methods: 88 cases of ANA indirect immunofluorescence and ENA immunoblotting inpatients were collected from Union Hospital, Wuhan, and clinical data were collected. Of the 46 SSA positive samples, the specific autoantibodies were determined by ELISA. The dilution ratio ANA was tested again with IIF at 1:32 and 1:10. Results: In 1 770 inpatients, the ANA IIF (-) LIA (+) pattern accounted for 4.97% of the 4 patterns. LIA positive antibodies have anti-SSA, anti-histone, anti-nRNP and so on. Compared with the IIF (-) LIA (-) control group, the positive rates of IL-1β in the two groups were higher at 1:32 (41.3% and 2.5% And 7.5% respectively) (all P <0.05). After the dilution was reduced from 1: 100 to 1:32 and 1:10, the positive rate of ANA increased. CONCLUSIONS: For ANA IIF (-) LIA (+) detection mode, reducing the dilution can reduce the missed detection of ANA, improve the consistency between IIF and LIA, and ensure the accuracy of clinical diagnosis.