摘要
目的探讨血清抗核周型中性粒细胞胞质抗体(p-ANCA)、抗酿酒酵母菌抗体(ASCA)、抗胰腺腺泡抗体(PAB)和抗小肠杯状细胞抗体(GAB)对福建省炎症性肠病(IBD)诊断和鉴别诊断的临床价值。方法间接免疫荧光法检测UC组[32例溃疡性结肠炎(UC)患者]、CD组[47例克罗恩病(CD)患者]及对照组(48例非IBD肠道疾病患者)血清中4种抗体的表达。结果 UC组的p-ANCA阳性率(37.5%)高于CD组(4.3%)和对照组(2.1%),CD组的PAB阳性率(70.2%)高于UC组(9.4%)和对照组(6.3%),差异均有统计学意义(P <0.05)。UC组、CD组、对照组的GAB阳性率比较,差异无统计学意义(P> 0.05)。p-ANCA阳性/PAB阴性诊断UC的敏感度、特异度、阳性预测值、阴性预测值分别为34.4%、97.9%、91.7%、68.7%;p-ANCA阴性/PAB阳性诊断CD的敏感度、特异度、阳性预测值、阴性预测值分别为68.1%、93.8%、94.1%、66.7%。结论 p-ANCA、PAB联合检测有助于鉴别UC和CD,p-ANCA阳性/PAB阴性提示UC,p-ANCA阴性/PAB阳性提示CD;GAB对于诊断IBD意义不大。
Objective To investigate the clinical significance of serumal perinuclear anti-neutrophil cytoplasmic antibody（p-ANCA）, anti-saccharomycescerevisiae anti-body（ASCA）, anti-intestinal goblet cell antibody（GAB）and anti-pancreatic antibody（PAB）in diagnosis and differential diagnosis ofinflammatory bowel disease（IBD）in Fujian Province. Methods Indirect immunofluorescence assay was applied to detect expression of four serum antibodiesin UC group[32 patients with ulcerative colitis（UC）], CD group[47 patients with Crohn’s disease（CD）]and control group（48 patients with non-IBD intestinaldisease）. Results The positive rate of p-ANCA in patients with UC was 37.5%, significantly higher than in CD group（4.3%, P 〈0.05）and control group（2.1%,P 〈0.05）. The positive rate of PAB in patients with CD was 70.2%, significantly higher than in UC group （9.4%, P 〈0.05） and control group （6.3%, P 〈0.05）.GAB had no significant difference between UC, CD, and control group（P 〉0.05）. The combination of a positive p-ANCA and a negative PAB（p-ANCA＋/PAB-）yielded a sensitivity, specificity, positive and negative predictive value of 34.4%, 97.9%, 91.7%and 68.7%, respectively for the diagnosis of UC. Thep-ANCA-/PAB＋had a sensitivity,specificity, positive and negative predictive value of 68.1%, 93.8%, 94.1%and 66.7%, respectively for diagnosis of CD.Conclusions The combination of p-ANCA and PAB is useful for differenting UC and CD, p-ANCA positive/PAB negative suggests the diagnosis of UC, andp-ANCA negative/PAB positive suggests the diagnosis of CD. No difference in the positive rates of GAB render it of little value in diagnosis of IBD.
作者
王玉萍
王承党
WANG Yu-ping;WANG Cheng-dang(Deptment of Gastrointestinal Endoscopy,The First Affiliated Hospital of Fujian Medical University,Fuzhou 350005,China;Deptment of Gastroenterology,the First Affiliated Hospital of Fujian Medical University,Fuzhou 350005,China)
出处
《中国医药指南》
2018年第34期19-20,共2页
Guide of China Medicine
关键词
炎症性肠病
溃疡性结肠炎
克罗恩病
血清学抗体
Inflammatory Bowel Disease
Ulcerative Colitis
Crohn’s Disease
Serum Antibodies
