抗中性粒细胞胞浆抗体在炎性肠病中的意义

被引：16

作者：

王晓娣

董恩钰

机构：

[1] 中日友好医院消化内科,中日友好医院消化内科

来源：

中华内科杂志 | 2000年 / 03期

关键词：

抗体,抗中性白细胞胞质; 结肠炎,溃疡性; Crohn病;

D O I：

暂无

中图分类号：

R574 [肠疾病];

学科分类号：

1002 ; 100201 ;

摘要：

目的　研究抗中性粒细胞胞浆抗体 (ANCA)在炎性肠病 (IBD)中的发生率、其针对的靶抗原及其与临床疾病活动性的关系。方法　用间接免疫荧光法对 76例溃疡性结肠炎 (UC)、36例克隆病 (CD)及 2 10例正常者进行ANCA的筛选测定 ,用ELISA检测ANCA针对的不同靶抗原。结果　 76例UC患者中血清ANCA阳性者占 71 1% ,均为核周型染色 ,明显高于CD患者ANCA的阳性率(8 3% ,P <0 0 0 1)。UC病人ANCA针对的抗原主要是增加通透性杀菌蛋白 (BPI)。BPI ANCA的阳性率与UC疾病活动度 (Truelove Witts分类法 )呈明显的正相关。血清BPI ANCA的水平与临床疾病活动参数如C 反应蛋白、血沉、肿瘤坏死因子 α和血清白蛋白的水平均呈显著相关 (P值均 <0 0 0 1) ,但BPI ANCA的存在与UC的病变部位、是否应用免疫抑制剂治疗无明显关系。结论　BPI是UC患者ANCA的主要靶抗原 ,BPI ANCA的检测不但有助于UC和CD的鉴别诊断 ,而且是判定UC疾病活动性的重要免疫学指标。该结果提示了UC和CD免疫病理机制的不同和UC发病机制的多样性。

引用

页码：15 / 18

页数：4

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