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目的比较免疫金银法和免疫荧光法检测抗核抗体对系统性红斑狼疮(SLE)的诊断价值。方法对SLE和其余6种自身免疫性疾病患者及健康人血清采用免疫金银染色法和间接免疫荧光法检测抗核抗体,并比较分析两种方法检测抗核抗体对SLE诊断的敏感性、特异性、正确率、阳性预测值、阴性预测值、Youden指数等指标。结果免疫金银法和免疫荧光法检测抗核抗体阳性率为:SLE患者100%和96%、类风湿关节炎患者10%和36%、强直性脊柱炎患者2%和13%、系统性硬皮病患者13%和73%、干燥综合征患者27%和82%、皮肌炎患者12.5%和37.5%、血管炎患者0%和17%、健康人0%和0%。统计分析显示免疫金银染色法检测抗核抗体对SLE诊断的特异性、正确率、阳性预测值及Youden指数较免疫荧光法高,且差异有统计学意义(P<0.05)。结论免疫金银法检测ANA对SLE具有高度的敏感性和特异性,因此临床上采用免疫金银法检测ANA用于对SLE的辅助诊断更有价值。
Objective To compare the diagnostic value of anti-nuclear antibodies against systemic lupus erythematosus (SLE) by immunogold-silver assay and immunofluorescence assay. Methods Anti-nuclear antibodies were detected by immunogold-silver staining and indirect immunofluorescence in serum of patients with SLE and other 6 autoimmune diseases and healthy individuals. The sensitivity of anti-nuclear antibodies to SLE diagnosis was compared by two methods. Sex, accuracy, positive predictive value, negative predictive value, Youden index and other indicators. Results The results of immunogold-silver staining and immunofluorescence showed that the positive rate of anti-nuclear antibody was 100% and 96% in patients with SLE, 10% and 36% in patients with rheumatoid arthritis, 2% and 13% in patients with ankylosing spondylitis, 13% and 73% of patients, 27% and 82% of patients with Sjogren’s syndrome, 12.5% and 37.5% of patients with dermatomyositis, 0% and 17% of patients with vasculitis, and 0% and 0% of healthy individuals. Statistical analysis showed that the specificities of anti-nuclear antibodies detected by immunogold-silver staining were higher than those of immunofluorescence, and the correct rate, positive predictive value and Youden index were higher than those of immunofluorescence (P <0.05). Conclusion Immuno gold-silver method for detection of ANA is highly sensitive and specific for SLE. Therefore, it is more valuable to detect ANA by immunogold-silver method in the clinical diagnosis of SLE.