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免疫血清学实验室数据的临床评估

[Clinical evaluation of immuno-serological laboratory data].

作者信息

Kasukawa R, Tojo J, Kuwana T, Obara K

机构信息

2nd Department of Internal Medicine, Fukushima Medical College.

出版信息

Rinsho Byori. 1996 Dec;44(12):1157-63.

PMID:8990934
Abstract

Clinical evaluations of various laboratory data from immuno-serological tests such as rheumatoid factor, anti-nuclear antibody, and other auto antibodies were reviewed. Rheumatoid factors (RF) were discussed in relation to positivity in various diseases, immunoglobulin class of RF, and correlation between titers of RF and circulating immune complex (IC). As a result, higher frequency and higher titers of IgA-RF were found in Sjögren syndrome patients. Titers of RF did not show disease activity of RA, but those of ESR and CRP did. Anti-nuclear antibodies (ANA) were discussed in relation to positivity in healthy subjects, specific antibodies and corresponding specific disease, correlation among titers of anti-dsDNA antibody, CH50 and circulating immune complex. As a result, an ANA frequency of 40% was found in healthy young women. Values of CH50 were much better than ANA titers for evaluating clinical activity in SLE patients. Findings of anti-cardiolipin antibody in thrombosis patients with connective tissue vascular disease (CVD), anti-centromere antibody in various CVD patients as well as CREST patients and primary biliary cirrhosis patients and anti-neutrophil cytoplasmic antibodies in various vascular diseases along with inflammatory bowel disease patients were presented. Finally, useful laboratory data at different clinical steps such as diagnosis, evaluation of disease activity and estimation of prognosis were demonstrated in CVD.

摘要

回顾了类风湿因子、抗核抗体及其他自身抗体等免疫血清学检测的各种实验室数据的临床评估。讨论了类风湿因子(RF)在各种疾病中的阳性情况、RF的免疫球蛋白类别以及RF滴度与循环免疫复合物(IC)之间的相关性。结果发现,干燥综合征患者中IgA-RF的频率和滴度较高。RF滴度未显示类风湿关节炎的疾病活动情况,但血沉(ESR)和C反应蛋白(CRP)的滴度显示了疾病活动情况。讨论了抗核抗体(ANA)在健康受试者中的阳性情况、特异性抗体及相应的特异性疾病、抗双链DNA抗体滴度、补体50(CH50)和循环免疫复合物之间的相关性。结果发现,健康年轻女性中ANA频率为40%。在评估系统性红斑狼疮(SLE)患者的临床活动时,CH50的值比ANA滴度要好得多。介绍了结缔组织血管疾病(CVD)血栓形成患者中抗心磷脂抗体的检测结果、各种CVD患者以及CREST综合征患者和原发性胆汁性肝硬化患者中抗着丝点抗体的检测结果,以及各种血管疾病患者以及炎症性肠病患者中抗中性粒细胞胞浆抗体的检测结果。最后,展示了CVD在不同临床阶段(如诊断、疾病活动评估和预后估计)有用的实验室数据。

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