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[原发性胆汁性肝硬化和原发性干燥综合征患者的抗核抗体模式]

[Patterns of anti-nuclear antibodies in patients with primary biliary cirrhosis and primary Sjögren syndrome].

作者信息

You Xin, Liu Wei, Zhang Xuan, Zhang Feng-Chun

机构信息

Department of Rheumatology, Pecking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730, China.

出版信息

Zhonghua Yi Xue Za Zhi. 2008 Jan 15;88(3):168-70.

Abstract

OBJECTIVE

To investigate the anti-nuclear antibody (ANA) patterns in the diagnosis of primary biliary cirrhosis (PBC) and primary Sjögren syndrome (SS).

METHODS

Serum samples from 61 cases of PBC, 28 cases of primary SS, and 11 cases of overlap syndrome of PBC and SS were collected to detect the ANA with indirect immunofluorescence staining, and the difference in ANA patterns was analyzed between the PBC and SS patients.

RESULTS

Antinuclear antibodies were detected in 85.2% of the PBC patients, with the following hierarchy of specificities: 37.7% being rim-like, 21.3% being discrete speckled, 18.0% being speckled, 8.2% being multiple nuclear dots, and 4.9% being anti-lamin; 89.3% of the primary SS patients was ANA positive with speckled antibody, only one of them presented discrete speckles (3.6%); and all of the PBC patients overlapped with SS (100%) were positive in ANA, and their contexture of ANAs was similar to those of the PBC patients: 45.5% being rim-like, 18.2% being discrete speckled, 18.2% being speckled, 18.2% being anti-lamin, and 9.1% being multiple nuclear dots. Rim-like pattern and multiple nuclear dots were statistically significant for the diagnosis of PBC, compared with primary SS (chi(2) = 14.236, 3.781, P < 0.01, < 0.05).

CONCLUSION

The ANA patterns of PBC are different from those of primary SS. Among them, rim-like pattern and multiple nuclear dots are highly specific nuclear patterns of PBC and may be useful in diagnosing individuals without anti-mitochondrial antibodies.

摘要

目的

探讨抗核抗体(ANA)模式在原发性胆汁性肝硬化(PBC)和原发性干燥综合征(SS)诊断中的应用。

方法

收集61例PBC患者、28例原发性SS患者及11例PBC与SS重叠综合征患者的血清样本,采用间接免疫荧光染色法检测ANA,并分析PBC和SS患者ANA模式的差异。

结果

85.2%的PBC患者检测到抗核抗体,其特异性依次为:周边型37.7%、颗粒型21.3%、斑点型18.0%、多核点型8.2%、抗板层素型4.9%;89.3%的原发性SS患者ANA呈斑点型阳性,仅1例为颗粒型(3.6%);所有PBC与SS重叠患者(100%)ANA均阳性,其ANA构成与PBC患者相似:周边型45.5%、颗粒型18.2%、斑点型18.2%、抗板层素型18.2%、多核点型9.1%。与原发性SS相比,周边型和多核点型对PBC诊断有统计学意义(χ² = 14.236,3.781,P < 0.01,< 0.05)。

结论

PBC的ANA模式与原发性SS不同。其中,周边型和多核点型是PBC高度特异的核型,可能有助于诊断无抗线粒体抗体的个体。

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