Department of Clinical Laboratory, Baoding NO.1 Central Hospital, Baoding, China.
Chengde Medical University, Chengde, China.
J Clin Lab Anal. 2019 Oct;33(8):e22965. doi: 10.1002/jcla.22965. Epub 2019 Jul 16.
In China, the incidence of autoimmune diseases is gradually increasing. To decrease the misdiagnosis rate of autoimmune diseases, we conducted an epidemiological investigation about the presence of antinuclear antibody (ANA) in healthy populations and analyzed the clinical characteristics of healthy population with both high titer of ANA and positive anti-SSA and AMA-M2.
Serum ANA titers were detected by indirect immunofluorescence (IIF), and other 15 types of ANA-specific antibodies were detected by line immunoassays.
In 25 110 individuals for routine examination, the positive rate of ANA titer >1:100 was 14.01%, of which the positive rate of female (19.05%) was higher than that of male (9.04%; P < 0.01). The positive rate of ANA titer >1:320 was 5.93%, of which the positive rate of female (8.68%) was higher than that of male (3.21%; P < 0.01). The specific antibodies were detected in 1489 of ANA-positive people with titer >1:320, and the top three detected antibodies were anti-Ro-52 (212), AMA-M2 (189), and anti-SSA (144). The abnormal rate of blood routine test, liver function test, and other clinical indicators in AMA-M2-positive population was significantly different from those in the control group. The abnormal rate of blood routine test, liver function test, and immune index in anti-SSA-positive population was higher than those in control group.
There was a high prevalence of ANA positive in healthy population. To avoid misdiagnosis, those who had symptoms of abdominal discomfort, pruritus, or fatigue with abnormal results of blood routine and liver function test should be examined for ANA, AMA-M2, anti-SSA as early as possible.
在中国,自身免疫性疾病的发病率逐渐升高。为降低自身免疫性疾病的误诊率,我们对健康人群进行了抗核抗体(ANA)的流行病学调查,并分析了 ANA 滴度高且同时阳性抗 SSA 和 AMA-M2 的健康人群的临床特征。
采用间接免疫荧光法(IIF)检测血清 ANA 滴度,采用线免疫印迹法检测其他 15 种 ANA 特异性抗体。
在 25 110 例常规体检者中,ANA 滴度>1∶100 的阳性率为 14.01%,其中女性(19.05%)高于男性(9.04%;P<0.01)。ANA 滴度>1∶320 的阳性率为 5.93%,其中女性(8.68%)高于男性(3.21%;P<0.01)。在 1489 例 ANA 滴度>1∶320 阳性者中检测到特异性抗体,前三位检测到的抗体分别是抗 Ro-52(212)、AMA-M2(189)和抗 SSA(144)。AMA-M2 阳性人群的血常规、肝功能等临床指标异常率与对照组相比差异有统计学意义,抗 SSA 阳性人群的血常规、肝功能和免疫指标异常率均高于对照组。
健康人群中 ANA 阳性率较高。为避免误诊,对于有腹部不适、瘙痒或疲劳等症状且血常规和肝功能检查异常者,应尽早检查 ANA、AMA-M2、抗 SSA。