论文部分内容阅读
目的研究抗酿酒酵母抗体(ASCA)和抗中性粒细胞胞浆抗体(pANCA)在炎症性肠病诊断与鉴别诊断中的意义。方法间接免疫荧光生物薄片法检测29例溃疡性结肠炎(UC)、34例克罗恩病(CD)及25例正常对照者血清中ASCA和pANCA的表达。结果pANCA在CD组、UC组和正常对照组中的阳性率分别为47.1%、69.0%和16.0%,UC组显著高于CD组(P<0.05)和正常对照组(P<0.05)。ASCA在上述3组中的阳性率分别为11.8%、58.6%和8.0%,UC组亦显著高于CD组(P<0.05)和正常对照组(P<0.05)。ASCA+/pANCA-诊断CD的敏感性、特异性、阳性预测值分别是0、89.7%和0;pANCA+/ASCA-诊断UC的敏感性、特异性和阳性预测值分别是20.7%、64.7%和33.3%。结论ASCA和pANCA阳性有利于炎症性肠病的诊断却不能敏感地筛选患者;ASCA和pANCA联合检测不能作为汉族UC和CD鉴别诊断的指标。
Objective To study the significance of anti-Saccharomyces cerevisiae antibody (ASCA) and anti-neutrophil cytoplasmic antibody (pANCA) in the diagnosis and differential diagnosis of inflammatory bowel disease. Methods Serum levels of ASCA and pANCA were detected by indirect immunofluorescence biopsy in 29 patients with ulcerative colitis (UC), 34 patients with Crohn disease (CD) and 25 normal controls. Results The positive rates of pANCA in CD group, UC group and normal control group were 47.1%, 69.0% and 16.0% respectively, which were significantly higher in UC group than those in CD group and normal control group (P <0.05). The positive rates of ASCA in the above three groups were 11.8%, 58.6% and 8.0%, respectively, which were significantly higher in UC group than those in CD group and normal control group (P <0.05). The sensitivity, specificity and positive predictive value of ASCA + / pANCA-diagnostic CD were 0, 89.7% and 0, respectively; the sensitivity, specificity and positive predictive value of pANCA + / ASCA-diagnosed UC were 20.7%, 64.7% and 33.3 %. Conclusions Positive ASCA and pANCA are good for the diagnosis of inflammatory bowel disease, but not sensitive screening of patients. Combined detection of ASCA and pANCA can not be used as an index for differential diagnosis of UC and CD in Han.