Feighery Conleth, Conlon Niall, Jackson John
Trinity College Centre for Health Sciences, St James Hospital, Dublin, Ireland.
Eur J Gastroenterol Hepatol. 2006 Nov;18(11):1173-5. doi: 10.1097/01.meg.0000243869.41207.f9.
Serological screening tests for coeliac disease have significantly advanced the diagnosis of this condition. The very high specificity (almost 100%) of anti-endomysial antibody detection has been repeatedly confirmed, whereas a lower specificity (90-95%) is found with anti-tissue transglutaminase antibody assays. In the study by Malekzadeh and colleagues, a group of study participants were identified with raised anti-tissue transglutaminase antibodies, but the endomysial antibody test was negative in 86%. Although many of these participants were found to have raised intra-epithelial lymphocytes in their small intestinal mucosa, there is currently insufficient evidence to confidently diagnose gluten-sensitive disease in these patients. Hence, their report that a minimum prevalence of 1:104 of gluten sensitivity is found in the general population of Iran is likely to be an over-estimate and requires confirmation.
乳糜泻的血清学筛查试验显著推动了该病的诊断。抗肌内膜抗体检测具有极高的特异性（几乎达100%），这一点已得到反复证实，而抗组织转谷氨酰胺酶抗体检测的特异性则较低（90 - 95%）。在Malekzadeh及其同事的研究中，一组研究参与者的抗组织转谷氨酰胺酶抗体水平升高，但其中86%的人肌内膜抗体检测呈阴性。尽管发现这些参与者中有许多人小肠黏膜上皮内淋巴细胞增多，但目前尚无足够证据能确诊这些患者患有麸质敏感疾病。因此，他们报告称在伊朗普通人群中麸质敏感的最低患病率为1:104，这很可能是高估了，需要进一步证实。
