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目的探讨抗中性粒细胞抗体(ANCA)、抗酿酒酵母抗体(ASCA)在炎症性肠病(IBD)诊断、鉴别诊断中的意义,分析其与病变程度及范围的关系。方法用酶联免疫吸附测定(ELISA)检测36例UC、20例CD、25例疾病对照者及30例健康对照者的血清ASCA-IgA、ASCA-IgG和ANCA水平。结果36例UC组血清ANCA水平和阳性率显著高于CD组、疾病对照组、健康对照组[ANCA水平:(24.43±34.24)×10-3U/L比(4.53±2.46)、(2.84±1.17)、(2.82±0.71)×10-3U/(L均P<0.01);阳性率:52.8%(19/36)比5.0%(1/20)、8.0%(2/25)和0%(0/30),χ2值分别为12.783、13.104、22.234,均P<0.01]。20例CD患者ASCA水平和阳性率均高于UC组、疾病对照组、健康对照组(均P<0.01)。ANCA和ANCA+/ASCA-诊断UC的敏感性、特异性分别为52.8%、96.0%和50.0%、97.3%,ASCA+和ASCA+/ANCA-诊断CD敏感性、特异性分别为55.0%、94.6%和50.0%、95.6%。ANCA的阳性率高低与UC的严重程度、病变范围无关,ASCA的阳性率高低与CD严重程度无关。结论 ANCA阳性有助于UC的诊断,ASCA阳性有助于CD的诊断,ASCA/ANCA联合检测有助于鉴别UC和CD。ANCA与UC患者病变程度及范围均无相关性,ASCA与CD患者临床严重程亦无相关性。
Objective To investigate the significance of anti-neutrophil antibody (ANCA) and anti-Saccharomyces cerevisiae antibody (ASCA) in the diagnosis and differential diagnosis of inflammatory bowel disease (IBD) and to analyze its relationship with the extent and extent of the disease. Methods Serum levels of ASCA-IgA, ASCA-IgG and ANCA were measured by enzyme-linked immunosorbent assay (ELISA) in 36 patients with UC, 20 patients with CD, 25 patients with disease control and 30 healthy controls. Results The serum ANCA level and positive rate in 36 UC patients were significantly higher than those in CD patients. The levels of ANCA, disease control group and healthy control group [ANCA level (24.43 ± 34.24) × 10-3U / L ratio (4.53 ± 2.46), (2.84 ± 1.17 (2.82 ± 0.71) × 10-3U / (L, P <0.01). The positive rate was 52.8% (19/36) than that of 5.0% (1/20), 8.0% (2/25) and 0% 0/30), χ2 values were 12.783, 13.104, 22.234, all P <0.01]. The ASCA level and positive rate of 20 CD patients were higher than those of UC group, disease control group and healthy control group (all P <0.01). The sensitivity and specificity of ANCA and ANCA + / ASCA-diagnosing UC were 52.8%, 96.0% and 50.0%, 97.3%, respectively. The sensitivity of ASCA + and ASCA + / ANCA- was 55.0%, 94.6% and 50.0 %, 95.6%. The positive rate of ANCA was not related to the severity of UC or the extent of the disease. The positive rate of ASCA was not related to the severity of CD. Conclusion ANCA positive contributes to the diagnosis of UC. Positive ASCA contributes to the diagnosis of CD. Combined detection of ASCA / ANCA may be helpful in differentiating UC and CD. There was no correlation between ANCA and the severity and extent of disease in patients with UC, nor did the clinical severity of ASCA and CD patients.