多种方法检测的各类血清抗体在儿童乳糜泻中的诊断价值
Diagnostic value of various serum antibodies detected by diverse methods in childhood celiac disease.
作者信息
Sacchetti L, Ferrajolo A, Salerno G, Esposito P, Lofrano M M, Oriani G, Micillo M, Paparo F, Troncone R, Auricchio S, Salvatore F
机构信息
Dipartimento di Biochimica e Biotecnologie Mediche, Universita Frederico II, Napoli, Italy.
出版信息
Clin Chem. 1996 Nov;42(11):1838-42.
The diagnostic performances of antiendomysium IgA detected on monkey esophagus and human umbilical cord smooth muscle, of antireticulin IgA, and of antigliadin IgA and IgG were calculated in 74 children with celiac disease (CD) or other gastrointestinal disorders. We also compared four methods for gliadin antibody detection. With a diagnostic specificity of 100%, diagnostic sensitivity was 94% for antireticulin IgA, 93% for antiendomysium IgA when detected on human umbilical cord smooth muscle, and 97% when detected on monkey esophagus. The diagnostic sensitivity for gliadin antibody was highest with an ELISA procedure, followed by fluorogenic detection (94% for IgG, 91% for IgA, 97% with IgA and IgG combined). Because of its high diagnostic sensitivity and ease and speed of use, the combined antigliadin IgG and IgA antibody assay is suitable for screening large groups of patients. In IgG- or IgA-positive cases, the more demanding and more specific antiendomysium IgA evaluation is required to confirm suspected CD.
在74例患有乳糜泻（CD）或其他胃肠道疾病的儿童中，计算了在猴食管和人脐带平滑肌上检测到的抗肌内膜IgA、抗网硬蛋白IgA以及抗麦醇溶蛋白IgA和IgG的诊断性能。我们还比较了四种检测麦醇溶蛋白抗体的方法。抗网硬蛋白IgA的诊断特异性为100%，诊断敏感性为94%；在人脐带平滑肌上检测时，抗肌内膜IgA的诊断敏感性为93%，在猴食管上检测时为97%。采用酶联免疫吸附测定（ELISA）法检测麦醇溶蛋白抗体时诊断敏感性最高，其次是荧光检测法（IgG为94%，IgA为91%，IgA和IgG联合检测为97%）。由于其高诊断敏感性以及使用的简便性和快速性，联合抗麦醇溶蛋白IgG和IgA抗体检测适用于对大量患者进行筛查。在IgG或IgA呈阳性的病例中，需要进行要求更高且更具特异性的抗肌内膜IgA评估以确诊疑似乳糜泻。
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