Akahoshi Tohru
Department of Laboratory Medicine, Kitasato University School of Medicine, Sagamihara.
Rinsho Byori. 2004 Sep;52(9):743-50.
Immunologic laboratory tests serve critical roles in the care of patients with various rheumatic diseases. These tests can provide relevant information of rheumatic diseases based on their immunopathophysiological condition. Although immunologic laboratory tests are quite useful for the determination of diagnosis and the estimation of disease activity, organ involvement and prognosis, they are frequently misused and resulted in an inappropriate diagnosis and treatment. Appropriate use of immunologic laboratory tests and accurate clinical interpretation of the test results can prevent false diagnosis and unnecessary treatment. In order to improve clinical care of patients with rheumatic diseases, clinicians caring patients with rheumatic disease should recognize meanings, characteristics and limitations of each result of immunologic laboratory testing. This article reviewed recent advances in immunologic laboratory testing such as antinuclear antibody, anti-DNA antibody and anti-neutrophil cytoplasmic antibody, and introduced guidelines for these testing. These guidelines based on evidences of EBM may contribute to the appropriate use of immunologic laboratory tests for rheumatic diseases.
免疫实验室检测在各类风湿性疾病患者的治疗中发挥着关键作用。这些检测能够依据风湿性疾病的免疫病理生理状况提供相关信息。尽管免疫实验室检测对于疾病诊断、疾病活动度评估、器官受累情况及预后判断颇为有用,但它们却常常被滥用,进而导致不恰当的诊断与治疗。合理运用免疫实验室检测并对检测结果进行准确的临床解读,能够避免误诊和不必要的治疗。为改善风湿性疾病患者的临床治疗,诊治风湿性疾病患者的临床医生应认识到免疫实验室检测各项结果的意义、特点及局限性。本文综述了抗核抗体、抗DNA抗体及抗中性粒细胞胞浆抗体等免疫实验室检测的最新进展,并介绍了这些检测的指南。这些基于循证医学证据的指南可能有助于风湿性疾病免疫实验室检测的合理应用。