Association between antinuclear antibody titers and connective tissue diseases in a Rheumatology Department
Association between antinuclear antibody titers and connective tissue diseases in a Rheumatology Department
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DOI：
10.1016/j.reuma.2016.03.019
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发表时间：
2017-05-01
影响因子：
1.5
通讯作者：
de la Iglesia Salgado, Jose Luis
中科院分区：
文献类型：
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作者：
Menor Almagro, Raul;Rodiguez Gutierrez, Juan Francisco;de la Iglesia Salgado, Jose Luis
目的：通过细胞底物 HEp-2 中观察到的间接免疫荧光法确定抗核抗体（ANA）的稀释标题，及其与风湿病科要求的 ANA 测试中诊断系统性结缔组织病的关系。方法：选择 2010 年 1 月至 2012 年 12 月期间首次到风湿病科就诊、未进行 ANA 测试的患者样本。记录稀释滴度、免疫荧光模式和抗原特异性。 2015年1月，对患者的诊断进行了评估，并将其分类为系统性结缔组织疾病（系统性红斑狼疮、干燥综合征、系统性硬化症、未分化结缔组织、抗磷脂综合征、混合性结缔组织和炎性肌病）或非系统性结缔组织疾病。结果：风湿病科要求的受试者中总共有1282项ANA测试，其中293项呈阳性，女性占多数（81.9%）。患有系统性结缔组织病的患者有 105 名，无系统性结缔组织病的患者有 188 名。对于 1/640 稀释度，连接体中的阳性预测值为 73.3%，而非连接体中的阳性预测值为 26.6%；对于值 >= 1/1,280，分别为 85% 和 15%。在进行多变量分析时，我们观察到 1/320 稀释 OR 3.069 (95% CI: 1.237-7.614; P=.016)、1/640 OR 12.570 (95% CI: 3.659-43.187; P=.000) 和 >= 1/1,280 OR 42.136 之间呈正相关（95% CI：8.604-206.345；P=.000）。结论：这些结果显示，在 ANA 风湿病科要求的针对系统性结缔组织病患者的首次测试中，关联标题稀释度 >= 1/320。这些患者的 VPP 高于其他医学专业之前的研究要求。这可能表明有针对性地应用测试的重要性。 2016 爱思唯尔西班牙公司，S.L.U.和西班牙风湿病协会和墨西哥风湿病学院。版权所有。
Objective: To determine the dilution titles at antinuclear antibodies (ANA) by indirect immunofluorescence observed in cell substrate HEp-2 and its association with the diagnosis of systemic connective tissue disease in ANA test requested by a Rheumatology Unit.Method: Samples of patients attended for the first time in the rheumatology unit, without prior ANA test, between January 2010 and December 2012 were selected. The dilution titers, immunofluorescence patterns and antigen specificity were recorded. In January 2015 the diagnosis of the patients were evaluated and classified in systemic disease connective tissue (systemic lupus erythematosus, Sjogren's syndrome, systemic sclerosis, undifferentiated connective, antiphospholipid syndrome, mixed connective tissue and inflammatory myophaty) or not systemic disease connective tissue.Result: A total of 1282 ANA tests requested by the Rheumatology Unit in subjects without previous study, 293 were positive, predominance of women (81.9%). Patients with systemic connective tissue disease were recorded 105, and 188 without systemic connective tissue disease. For 1/640 dilutions the positive predictive value in the connective was 73.3% compared to 26.6% of non-connective, and for values >= 1/1,280 85% versus 15% respectively. When performing the multivariate analysis we observed a positive association between 1/320 dilution OR 3.069 (95% CI: 1.237-7.614; P=.016), 1/640 OR 12.570 (95% CI: 3.659-43.187; P=.000) and >= 1/1,280 OR 42.136 (95% CI: 8.604-206.345; P=.000).Conclusion: These results show association titles dilution >= 1/320 in ANA's first test requested by a Rheumatology Unit with patients with systemic connective tissue disease. The VPP in these patients was higher than previous studies requested by other medical specialties. This may indicate the importance of application of the test in a targeted way. 2016 Elsevier Espana, S.L.U. and Sociedad Espanola de Reumatologia y Colegio Mexicano de Reumatologia. All rights reserved.