抗核抗体检测临床价值评估.docVIP

抗核抗体检测临床价值评估 　【摘要】 目的：初步评估抗核抗体(ANA)检测的临床价值。方法：回顾分析872例ANA检测患者资料，作统计学分析。结果：皮肤病变、关节症状、肾脏病变3类临床征象组ANA阳性率明显高于其他临床征象组，ANA检测有较高的灵敏度(Plt;0.05)；ANA检测对皮肤病变、肾脏病变2类临床征象组有较高特异性，明显高于其他组(阴阳性组百分率u检验，Plt;0.05)。 ANA检测时对SLE和其他风湿性疾病的灵敏度、特异性、阳性率分别为94.5％、66.7％、15.3％和63.7％、52.6％、11.4％。其总体阳性率较低，仅为26.7％。结论：就临床征象而言，ANA检测对于皮肤病变、关节症状、肾脏病变具有较高的灵敏度，对皮肤病变、肾脏病变具有较高的特异性，但对除此之外的其他征象(如发热等)灵敏度和特异性较差。就疾病而言，ANA检查对SLE和其他风湿性疾病特异性较高，而仅对SLE有较高的灵敏度。ANA检测的阳性检出率强烈地依赖于受检对象的选择，而且具有一定的假阳性率，不宜作为普通人群的风湿性疾病筛选检查。 【关键词】 抗核抗体 风湿性疾病 临床价值 　　Evaluation of the Clinical Value of ANA Detection Abstract: Objective To evaluate tentatively clinical value estimate for Antinuclear antibodies (ANA)EIA detection. Methods Retrospective and statistics analysis had been done to 872 patients tested with ANA EIA. Results The ANA positive rates in the 3 clinical symptom groups of skin symptom, joint symptom and kidney symptom was higher than those of other clinical symptom groups. ANA EIA had higher sensitivity obviously(Plt;0.05)；For skin or kidney symptom, ANA EIA had higher specificity obviously(Plt;0.05).For SLE and other rheumatic disease, the sensitivity, specificity and positive rates of ANA EIA were 94.5％,66.7％,5.3％ and 63.7％,52.6％,11.4％.Its total positive rate was lower only to 26.7％. Conclusion As to clinical symptom，ANA EIA has higher sensitivity in skin symptom, joint symptom and kidney symptom, has higher specificity in skin or kidney symptom, but lower sensitivity and specificity in other clinical symptom. While for disease，and positive rates ANA EIA has higher specificity in SLE and other rheumatic disease，but higher sensitivity only in SLE. The ANA EIA positive rate depends on the choice of patients strongly, and there is a certain false positive rate, so it is not suitable for ordinary people to screen rheumatic disease. Key words: Antinuclear Antibodies (ANA)；Rheumatic disease；Clinical value 在自身免疫性疾病中，细胞核常成为自身免疫反应的重要靶子，细胞核的核膜、核内染色质、非组蛋白，以及由核糖核酸(RNA)和相关的蛋白质构成的各种核糖蛋白粒子等都可成为自身免疫反应攻击的靶子，产生抗核抗体(ANA)。随着医学科学的发展, 对ANA的理解已不