血清抗体检测在炎症性肠病中临床应用研究.docVIP

血清抗体检测在炎症性肠病中临床应用研究 　　【摘要】 目的 研究抗胰腺外分泌腺抗体（PAB）、抗酿酒酵母抗体（ASCA）、抗杯状细胞抗体（GAB）及抗中性粒细胞胞浆抗体（pANCA）在炎症性肠病（IBD）诊断与鉴别诊断中的意义。方法 间接免疫荧光生物薄片法测定UC组[30例溃疡性结肠炎（UC）患者]、CD组[22例克罗恩病（CD）患者]及正常对照组（20例健康体检者）血清中四种血清学抗体的表达。结果 pANCA在UC组阳性率（56.7%）高于CD组（9.1%）和正常对照组（5.0%）（P0.05）；GAB在正常对照组及IBD患者中均未见表达；PAB在CD组阳性率（27.3%）高于UC组（0）和正常对照组（0）（P0.05）；ASCA在CD组阳性率（45.5%）高于UC组（3.3%）和正常对照组（0）（P0.05）。pANCA检测诊断IBD敏感性为36.5%， 特异性为95.0%；GAB、PAB及ASCA单项检测诊断IBD敏感性较低， 分别为0、11.5%、21.2%， 但其诊断IBD特异性较高为100.0%。结论 pANCA、GAB、PAB及ASCA在IBD诊断中敏感性低， 特异性高。 　　【关键词】 炎症性肠病；克罗恩病；溃疡性结肠炎；抗体 　　DOI：10.14163/j.cnki.11-5547/r.2016.26.001 　　【Abstract】 Objective To research significance by anti-pancreatic antibody （PAB）， anti-sacchromyces cerevisia antibody （ASCA）， anti-goblet cell antibody （GAB） and perinuclear anti-neutrophil cytoplasmic antibody （pANCA） in diagnosis and differential diagnosis of inflammatory bowel disease （IBD）. Methods Indirect immunofluorescent biological chip test was applied to detect expression of four serum antibodies in UC group [30 patients with ulcerative colitis （UC）]， CD group [22 patients with Crohns disease （CD）] and normal control group （20 healthy people）. Results Positive rate of pANCA was higher in UC group （56.7%） than CD group （9.1%） and normal control group （5.0%） （P0.05）. GAB was not shown in normal control group and IBD patients. PAB had higher positive rate in CD group （27.3%） than UC group （0） and normal control group （0） （P0.05）. Positive rate of ASCA was higher in CD group （45.5%） than UC group （3.3%） and normal control group （0） （P0.05）. Detection of pANCA showed sensibility as 36.5% and specificity as 95.0% in diagnosis of IBD. Single detection of GAB， PAB and ASCA showed low sensibility in diagnosing IBD as 0， 11.5% and 21.2%. Specificity by detection of the four antibodies was high as 100.0% in diagnosing IBD. Conclusion In diagnosis of IBD， pANCA， GAB， PAB and ASCA contain low sensibility but high specificity. 　　【Key words】 Inflammatory bowel disease； Crohns disease； Ulcerative coli