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炎症性肠病中的抗中性粒细胞胞浆自身抗体

[antineutrophil cytoplasmic autoantibodies in inflammatory bowel disease].

作者信息

Papo M, Quer J C, Pastor R M, García-Pardo G, Olona M, Prats E, Mirapeix E, Rodríguez R, Richart C

机构信息

Sección de Aparato Digestivo, Hospital Universitario de Tarragona Joan XXIII, Universitat Rovira i Virgill.

出版信息

Med Clin (Barc). 1998 Jan 17;110(1):11-5.

PMID:9527980
Abstract

BACKGROUND

The aim of the present study was to determine the prevalence and diagnostic usefulness of antineutrophil cytoplasmic antibodies (ANCA) in a Spanish population of patients with inflammatory bowel disease from the province of Tarragona.

PATIENTS AND METHODS

One hundred and fifty-six sera obtained from 116 patients with inflammatory bowel disease (75 ulcerative colitis and 41 Crohn's disease) and 40 healthy controls were tested using an indirect immunofluorescence assay.

RESULTS

ANCA were detected in 65% of patients with ulcerative colitis but in only 12% of patients with Crohn's disease (p < 0.01), and 2.5% of control subjects (p < 0.01). The overall sensitivity of the test for the diagnosis of ulcerative colitis was 65% with a specificity of 88% and a positive predictive value of 91%. Among patients with ulcerative colitis there was no relationship between the presence or titre of ANCA and the duration, the clinical course, the extent, the disease activity or the need for medical treatment.

CONCLUSIONS

In the population studied, ANCA occur more commonly in ulcerative colitis than in Crohn's disease, as reported in other populations. Their determination in patients with inflammatory bowel disease may be useful to differentiate ulcerative colitis from Crohn's disease.

摘要

背景

本研究的目的是确定塔拉戈纳省西班牙炎性肠病患者中抗中性粒细胞胞浆抗体(ANCA)的患病率及其诊断价值。

患者与方法

使用间接免疫荧光法检测了116例炎性肠病患者(75例溃疡性结肠炎和41例克罗恩病)和40例健康对照者的156份血清。

结果

溃疡性结肠炎患者中65%检测到ANCA,而克罗恩病患者中仅12%检测到(p<0.01),对照者中为2.5%(p<0.01)。该检测对溃疡性结肠炎诊断的总体敏感性为65%,特异性为88%,阳性预测值为91%。在溃疡性结肠炎患者中,ANCA的存在或滴度与病程、临床过程、病变范围、疾病活动度或治疗需求之间无相关性。

结论

在所研究的人群中,与其他人群的报道一样,ANCA在溃疡性结肠炎中比在克罗恩病中更常见。在炎性肠病患者中检测ANCA可能有助于鉴别溃疡性结肠炎和克罗恩病。

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