环型抗核抗体的临床意义-风湿免疫内科专业论文.docxVIP

： ： 主里塑塑垦型!堂堡主丝苎————————————————～ 摘 要 研究目的：深入认识环型抗核抗体(ANA)，并初步探讨环型ANA在 我国风湿免疫性疾病中的分布及临床意义。 方法：检索1998年12月至2002年12月间1840份确诊为风湿免疫性 疾病(包括PBC 65例，AIH 35例，pSS 356例，SLE 1012例，RA 298 例，PM 74例)的病例，其中49例环型ANA阳性，对抗体阳性的病 例进行回顾性分析，计算环型ANA在各疾病中的阳性率，比较29例 环型ANA阳性的PBC患者和27例阴性的PBC患者的临床表现和实 验室检查等方面的差异。 结果：环型ANA在PBC中的阳性率为56．9％，AIH为2．9％，pSS为 1．7％，SLE为O．2％，RA为0．7％，PM为1．4％。环型ANA诊断PBC 的敏感性是56．9％，特异性是99．3％。29例环型ANA阳性的PBC与 27例阴性的PBC比较临床表现、实验室检查指标，两组间无显著性差 异(胗O．05)。29例环型ANA阳性的患者中有6例AMzA阴性，而27 例抗体阴性的患者中仅l例AM2A阴性。 结论：环型ANA对诊断PBC的敏感性和特异性高，特别是对AMA 阴性的PBC患者的诊断有意义。环型ANA阳性的PBC患者和阴性患 者在l艋床表现和实验室检查上无差异。环型ANA的临床意义还需进～ 步深入研究。 关键词 抗核抗体抗核被膜蛋白抗体原发性胆汁性肝硬化 ±曼垫翌垦型查堂!生兰兰————————————————一ABSTRACT ±曼垫翌垦型查堂!生兰兰————————————————一 ABSTRACT OBJECTIVE：Review the characteristics of ring-like antinuclear antibody and the clinical significance．Explore the distribution and the clinical significance ofthe ring-like ANA in different rheumatic diseases． METHOD：Collecting 1 840 patients，including 65 patients diagnosed of PBC，35 patients of AIH，356 patients of pSS，1012 patients of SLE， 298 patients of RA，and 74 patients of PM,49 patients were tested ring-like ANA positive in our hospital．The prevalence and specificity of these antibodies was studied in 65 patients with PBC and 1775 control patients．And the clinical and laboratory data of patients with ring-like ANA positive were reviewed． RESULT：Prevalence of ring-like ANA in PBC is 56．9％，2．9％in AIH。 1．7％in pSS，0．2％in SLE，O．7％in RA，1．4％in PM．The sensitivity and specificity of the ring—like ANA Are 56．9％and 993％respectively．No difference was found between the ring-like ANA positive PBC patients and the negative ones with respect to clinical and laboratory features．What is more important，6 patients among of 29 PBC patients with ring-like ANA positive were tested AM2A negative． CONCLUSION：The ring—like ANA Are highly specific for the diagnosis of PBC，especially in cases in which antimitochondrial antibodies are not 4 中国协和医科大学硕士论文detectable．The 中国协和医科大学硕士论文 detectable．The clini