摘要
目的探讨自身免疫性肝病(AILD)合并血管炎患者检测血清抗中性粒细胞胞质抗体(AN-CA)、IgG4的临床意义。方法选取AILD合并血管炎患者67例,AILD未合并血管炎患者170例、非AILD患者132例及健康体检者43例,采用间接免疫荧光法(IIF)检测ANCA和速率散射比浊法检测IgG4,并对结果进行统计分析。结果原发硬化性胆管炎(PSC)合并血管炎患者ANCA阳性率最高为68.97%,与非AILD、健康对照组差异均具有统计学意义(P<0.01);PSC合并血管炎IgG4水平最高为(131.17±123.66)mg/d L,与AILD未合并血管炎组、非AILD组、健康对照组比较,差异均具有统计学意义(P<0.01);PSC合并血管炎IgG4水平AUC=0.845,P<0.01,95%置信区间为0.737~0.952,曲线下面积最大,诊断价值最高。结论 ANCA、IgG4检测对于AILD合并血管炎患者的血清学诊断及鉴别诊断具有重要的临床意义,其中对PSC合并血管炎鉴别诊断意义最显著。
Objective To investigate the clinical significance of the detection of serum Anti-neutrophil cytoplasmic antibodies(ANCA)and IgG4 in autoimmune liver disease(AILD)patients with vasculitis.Methods A total of 67 AILD patients with vasculitis,170 AILD patients without vasculitis,132 non-AILD patients and 43 healthy physical examinees were involved,and the serum level of ANCA was measured by indirect immunofluorescence(IIF)and rate-scatter turbidimetric method was used for the detection of IgG4.The results were statistically analyzed.Results The positive rate of ANCA in the primary sclerotic cholangitis(PSC)patients with vasculitis were 68.97%,and the differences between non-AILD and healthy control group were statistically significant(P<0.01).The level of IgG4in the PSC patients with vasculitis was up to(131.17±123.66)mg/dL,and the differences in AILD without vasculitis,non-AILD,and healthy control group were significant statistically(P<0.01).AUC of IgG4 of PSC patients combined with vasculitis was 0.845(P<0.01);95%confidence interval was 0.737~0.952 and the curve area was the largest and the diagnostic value was the highest.Conclusion ANCA and IgG4 have important clinical significance for the serological diagnosis and differential diagnosis of patients with AILD complicated with vasculitis,especially of PSC patients with vasculitis.
作者
谭立明
吴思凡
郑葳
钟彩舟
付慧颖
王巧花
隆婷婷
管晓琳
蒙仪妹
吴洋
曾婷婷
田永建
余建林
陈娟娟
李华
曹莉萍
TAN Liming;WU Sifan;ZHENG Wei;ZHONG Caizhou;FU Huiying;WANG Qiaohua;LONG Tingting;GUAN Xiaolin;MENG Yimei;WU Yang;ZENG Tingting;TIAN Yongjian;YU Jianlin;CHEN Juanjuan;LI Hua;CAO Liping(Department of Clinical Laboratory Science,The Second Affiliated Hospital of Nanchang University,Jiangxi Province Key Laboratory of Laboratory Medicine,Nanchang 330006,China)
出处
《实用医学杂志》
CAS
北大核心
2018年第14期2410-2415,共6页
The Journal of Practical Medicine
基金
国家自然科学基金项目(编号:81760382)
江西省科技计划项目(编号:20151122070198,20151BBG70179)
