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目的 联合测定血清抗酿酒酵母菌抗体 (ASCA) IgG、ASCA IgA和核周型抗中性粒细胞胞浆抗体 (pANCA)水平 ,探索其对克罗恩病 (CD)和溃疡性结肠炎 (UC)的诊断和鉴别诊断意义。 方法 分别应用标准化ELISA法和间接免疫荧光法对 19例炎症性肠病 (IBD ,UC10例 ,CD9例 )患者和 18名健康对照者血清ASCA IgG、ASCA IgA和pANCA水平进行测定。 结果 9例CD患者 (末段回肠和结肠均累及 )血清ASCA IgG和ASCA IgA水平 (酶单位 )分别为18.5 1± 6 .38和 11.74± 5 .4 6 ,显著高于10例UC患者 (6 .98± 5 .2 4和 3.88± 3.5 2 )和 18名健康对照者 (5 .90± 4 .12和 4 .6 2± 3.2 1,P值均 <0 .0 5 ) ,pANCA诊断UC的敏感性为 80 % ,而CD患者和健康对照者的阳性检测率均为 0 %。结论 AS CA是一种对CD具有特异性的抗体 ,pANCA是与UC显著正相关的一个免疫学指标。它们均有助于CD与UC的诊断和鉴别诊断 ,是IBD非创伤性鉴别诊断方法之一。
Objective To determine the levels of anti-Saccharomyces cerevisiae antibody (ASCA) IgG, ASCA IgA and perinuclear anti-neutrophil cytoplasmic antibody (pANCA) in patients with Crohn’s disease (CD) and ulcerative colitis ) Diagnosis and differential diagnosis. Methods Serum levels of ASCA IgG, ASCA IgA and pANCA in 19 inflammatory bowel disease (IBD, UC10, CD9) and 18 healthy controls were determined by standard ELISA and indirect immunofluorescence respectively. Results Serum levels of ASCA IgG and ASCA IgA (enzyme units) were 18.5 1 ± 6 .38 and 11.74 ± 5. 46 in 9 patients with CD (all involved in the distal ileum and colon), which were significantly higher than those in 10 UC patients (6 .98 ± 5.24 and 3.88 ± 3.52) and 18 healthy controls (5.90 ± 4.12 and 4.2 ± 3.2 1, P <0.05) Sensitivity was 80%, while the positive rate of CD patients and healthy controls were 0%. Conclusions AS CA is an antibody specific to CD, and pANCA is a significantly positive correlation with UC. All of them contribute to the diagnosis and differential diagnosis of CD and UC, and are one of the non-invasive differential diagnosis methods of IBD.