Characteristic analysis of the clinical expressions of antinuclear antibody and antibody profiles in com-mon joint diseases

doi:10.3969/j.issn.1674-7151.2015.02.003

Abstract：Objective To explore the clinical significance of antinuclear antibody (ANA) and antinu-clear antibody spectrum (ANAs) detecting in the diagnosis of common joint diseases. Methods The clinical data of 452 cases patients with joint disease in our hospital from January 2013 to October 2014 were collected and retrospectively analyzed. The patients were divided into osteoarthropathy group 63 cases , rheumatoid arthritis(RA) group 291 cases and gouty arthritis group 98 cases according to the clinical diagnosis. The distri-butions of ANA and ANAs in different disease groups were analyzed respectively. The different expression combinations of ANAs among different diseases, as well as the differential expressions of the ANA fluorescent types among different disease groups were further analyzed. The results were analyzed statistically. Results (1)There was 170 cases (37.6%,170/452) patients showed ANA+, 88 cases (19.5%,88/452) ANA+/ANAs+, 82 cases (18.1%,82/452) ANA+/ANAs-, and no ANA-/ANAs+was found among 452 cases pa-tients. There was statistical significance in the difference of ANA and ANAs results (χ2=177.98, P=0.000). (2)There were 18 cases(28.6%,18/63) patients with osteoarthropathy showed ANA+, and found 6 kinds flu-orescent types, of which cytoplasm was the most(44.4%,8/18);There were 146 cases(50.2%,146/291) pa-tients with RA showed ANA+, and found 13 kinds fluorescent types, of which the homogeneous type (32.2%, 47/146) was the most; There were 6 cases (6.1%,6/98) patients with gouty arthritis showed ANA+, and found 5 kinds fluorescent types, all of which appeared in no more than 2 cases;There was statistical signifi-cance in the ANA positive rate among three joint disease groups (P=0.000), and some fluorescent types of ANA were associated with different joint diseases(χ2=21.43, P=0.018). (3)There were 6 cases(9.5%,6/63) patients with osteoarthropathy showed ANAs+, and found 6 kinds antibodies. There were 78 cases (26.8%,78/291) patients with RA showed ANAs+, and found 10 kinds antibodies. There were 4 cases (4.1%,4/98) pa-tients with gouty arthritis showed ANAs+, and found 3 kinds antibodies. There was statistical significance in the ANAs positive rate among three joint disease groups(P=0.000). 31 combinations were found in all ANAs+, including 5 combinations in osteoarthropathy group, 29 combinations in RA group, and 3 combinations in gouty arthritis group, in which AntiRo52/AntiRo60/AntiSSB, AntiRo52, AntiRo52/AntiRo60, AntiRo60 and AntiU1nRNP appeared in at least two diseases;(4)Different positive combinations of ANAs for the same fluo-rescent type of ANA could be observed in different diseases. Conclusion There was correlation between ANA and ANAs results, but we can not infer the expression of the specific antibodies of ANAs relying on the fluores-cent types of ANA. Different fluorescent types of ANA and different positive combinations of ANAs can provide important references for relevant disease diagnosis and treatment, and the diversified expressions of ANA and ANAs in RA and their complexity should provide more referential value for the diagnosis and treatment.