抗聚糖抗体测定在炎症性肠病诊断中的意义

发布时间：2018-03-16 12:45

本文选题：克罗恩病　切入点：溃疡性结肠炎　出处：《浙江大学》2014年硕士论文　论文类型：学位论文

【摘要】：目的：探讨5种抗聚糖抗体分别及联合测定对克罗恩病诊断的价值。方法：该研究对IBD患者及对照组进行了临床数据和生化结果的分析,研究对象选取选取2013年1月至2014年4月在本院消化内科门诊及住院患者。IBD患者111例：溃疡性结肠炎41例,克罗恩病70例,并根据维也纳分型标准对CD患者进行分组,疾病对照组患者46例,健康对照组28例。抗体测定采用间接酶联免疫吸附技术,数据分析运用统计软件SPSS18.0, P0.05认为有统计学差异。结果：本实验中,结果最好的为抗体AMCAIgG. AMCAIgG在CD患者组中的阳性率明显高于其他各组的阳性率(P0.01),在CD患者中其敏感性高达45.7%,与各组相比特异性达92-95%。ASCA IgG的结果较好,在CD患者组中的阳性率明显高于其他3组,(P0.05),在CD患者中的阳性率为18.6%,与各组相比特异性均达95%以上。接下来依次为ASCAIgA, ALCAIgG, ACCAIgA。联合测定时,5种联合方式均能鉴别CD组与其他3个对照组。其敏感性及特异性差异较大。组合1(5种抗体中至少1种阳性)：敏感性75.7%,特异性在65-80%之间。组合2(5种抗体中至少2种阳性)：敏感性为40%,特异性在80-90%之间。组合3(ASCAIgG, ASCAIgA, AMCA, ALCA4种抗体至少1种阳性)：敏感性高,达72.9%,特异性偏低,在70-85%之间。组合4(ASCAIgG, AMCA2种抗体中1种阳性,或其他3种抗体中至少2种阳性。)：敏感性60%,特异性在78-90%之间。组合5(ASCA IgG, AMCA2种抗体中1种阳性。)：敏感性达54.3%,特异性在87-95%之间。结论：5种抗聚糖抗体对于IBD的诊断及鉴别诊断均有一定的意义,其中UMCAIgG及ASCAIgG对CD的诊断意义最大,接下来依次为ASCAIgA, ALCAIgG, ACCA IgA。本实验中组合4(ASCAIgG, AMCA2种抗体中至少1种阳性,或其他3种抗体中至少2种阳性)及组合5的联合方式(ASCAIgG, AMCA2种抗体中至少1种阳性)对CD的诊断作用较好。
[Abstract]:Objective: to evaluate the value of five anti-glycan antibodies in diagnosis of Crohn's disease. Methods: the clinical data and biochemical results of the patients with IBD and the control group were analyzed. The subjects were selected from January 2013 to April 2014 in the Department of Digestive Medicine and the inpatient of our hospital: 41 patients with ulcerative colitis, 41 patients with ulcerative colitis, 41 patients with ulcerative colitis, 41 patients with ulcerative colitis from January 2013 to April 2014. Seventy patients with Crohn's disease were divided into two groups according to the Vienna classification criteria: 46 patients in the disease control group and 28 in the healthy control group. Indirect enzyme-linked immunosorbent assay (Elisa) was used for the determination of antibodies. Statistical software SPSS 18.0 was used for data analysis. Results: in this experiment, the best result was that the positive rate of AMCAIgG in CD group was significantly higher than that in other groups (P 0.01), and the sensitivity was as high as 45.7 in CD patients, and the specificity was 92-95.ASCA IgG. The positive rate in CD group was significantly higher than that in the other three groups (P 0.05), and the positive rate in CD patients was 18.6, and the specificity was over 95% compared with each group. The next order was ASCA IgA, ALCA IgG, ACCA IgA. The sensitivity and specificity of these antibodies were significantly different from those of the other three control groups. The sensitivity was 75.75.75%, the specificity was 65-80%, and the sensitivity was 40%, and the specificity was between 65% and 80%. The sensitivity was 40% and the specificity was 40%. In the range of 80-90%. Combination of 3 AGC, ASCA IgA, AMCA, ALCA4 antibodies at least one positive: high sensitivity, Up to 72.9%, the specificity was low, between 70-85%. Or at least 2 of the other three antibodies: sensitivity is 60, specificity is between 78 and 90%. Combination of 5 ASCA IgG, 1 positive in AMCA2 antibody: sensitivity is 54.3%, specificity is between 87 and 95%. Conclusion five kinds of anti-glycan antibodies are of significance for the diagnosis and differential diagnosis of IBD, among which UMCAIgG and ASCAIgG have the greatest significance in the diagnosis of CD, followed by ASCA IgA, ALCA IgG, ACCA IgA. Or at least 2 of the other 3 antibodies) and combination 5 combined with ASCAIgG and at least one of the AMCA2 antibodies were better in the diagnosis of CD.
【学位授予单位】：浙江大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R574

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