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Along with the rapid development of biomedical technology and the clinical application of anti-neutrophil cytoplasmic antibody ( ANCA ) , the detection of ANCA by indirect immunofluorescence ( IIF) and the detection of specific autoantibodies of ANCA by various immunological methods have also been developed , which promoted the standardization of ANCA′s laboratory testing procedures .These advances have brought new opportunities and challenges to ANCA′s laboratory testing technology and its clinical application.
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Objective To explore the clinical characteristic,level of plasma renin angiotensin (PRA),plas-ma angiotensin Ⅱ(Ang Ⅱ)and plasma aldosterone(Aldo)in the sleep apnea hypopnea syndrome (SAHS)patients, and to investigate the association between SAHS and hypertension.Methods The patients were selected for the study who were monitored with polysomnography.They were divided into SAHS group and non-SAHS group according to apea-hypopnea index(AHI),and there were 180 patients in the SAHS group,175 patients in the non-SAHS group. The systolic blood pressure(SBP),diastolic blood pressure(DBP)and the level of PRA,plasma Ang II and plasma Aldo were compared by variance analysis.Results The gender composition was different between the two groups,and had statistically significant difference(χ2 =16.30,P <0.01).The data of age,body mass index,neck circumference, waistline,DBP,SBP in SAHS group were significantly higher than those in non-SAHS group,and the differences were statistically significant(t =6.84,8.19,9.84,6.63,7.08,5.45,all P <0.01 ).The prevalence of hypertension in SAHS group was 46.58%,which was higher than 18.20% in non-SAHS group,and the difference had statistically significant(χ2 =46.71,P <0.01).The AHI had positive correlation with SBP,DBP,and they had statistically signifi-cant differences (rs =0.162,0.228,all P <0.01).The levels of PRA and plasma Ang Ⅱ were lower in SAHS group than those in non-SAHS group,while the level of plasma Aldo was higher in SAHS group than that in non-SAHS group,and had statistically significant differences(F =15.41,14.21,17.67,all P <0.01).In the SAHS group,the levels of PRA and plasma Ang Ⅱ were lower in hypertension group than those in non-hypertension group,while the level of plasma Aldo was higher in hypertension group than that in non-hypertension group,and had statistically signif-icant differences (F =15.41,14.21,17.67,all P <0.01).Also,the levels of PRA and plasma Ang Ⅱ were lower in SAHS group with hypertension than those in non-SAHS group with hypertension,while the level of plasma Aldo was higher in SAHS group with hypertension than that in non-SAHS group with hypertension,and the differences were sta-tistically significant(F =15.41,14.21,17.67,all P <0.01).Conclusion The occurrence of SAHS is correlated with the gender composition,age,body mass index,neck circumference,waistline,DBP and SBP.In SAHS complica-tions in each system,the highest incidence is hypertension.And the AHI has positive correlation with SBP,DBP,and the difference is significant.In the SAHS group,if the AHI is higher,the risk of hypertension is greater.In the SAHS patients with hypertension,the level of plasma Aldo is significantly elevated,while the levels of PRA and plasma AngⅡ are decreased significantly.
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Objective To explore the prevalence of the nuclear dense fine speckled ( DFS ) immunofluorescence pattern in routine antinuclear antibodies(ANA) testing and its significance in patients with autoimmune diseases( AID) .Methods The ANA in 13 728 specimens were measured by indirect immunofluorescence( IIF) using HEp-2 cell slides from department of clinical laboratory, wenling hospital from 2011 to 2014.The frequencies, clinical manifestations and laboratory features of DFS positivity were restrospectively analyzed in patients with AID,usingχ2 test.Results ANA was positive in 20.56%(2 822/13 728) of the total patients, and the frequency of DFS pattern was observed in 1.81%(248/13 728) of the total patients and in 8.79%(248/2 822) of the patients with ANA positivity.In different age groups (≤20 years old, 21-49 years old and≥50 years old) , there were statistical significance of DFS pattern positive rate (male:χ2 =18.17,P<0.01; female: χ2 =1 500.00,P<0.01).And the highest frequency of ANA positivity was observed in patients from department of rheumatology(30.07%).The frequency of DFS pattern was higher in the departments of infection ( 32.58%) , dermatology ( 21.76%) , neurology ( 18.58%) and nephrology(6.73%) among the patients with ANA positivity(χ2 =123.00,P<0.01).Amony the 248 cases with DFS pattern positivity.41 cases were AID ( 16.53%) and 207 cases were non-autoimmune diseases ( 83.47%) . In AID group 13 cases were autoimmune thyroiditis ( 31.71%) , 12 cases were rheumatoid arthritis ( 29.27%) , 4 cases were autoimmune liver disease ( 9.76%) , 4 cases were undifferentiated connective tissue disease (9.76%), 3 cases were ankylosing spondylitis(7.32%), 2 cases were Sj?gren′s disease ( 4.88%) , 2 cases were inflammatory bowel disease ( 4.88%) and 1 case was systemic lupus erythematosus(2.44%).The titers of DFS in patients with AID were predominantly above 1∶320 and less than 1∶100 in non-AID.AID patients with DFS pattern positivity have different clinical manifestations and laboratory features.Howerer, antinuclear antibodies ( ANAs ) in 15 specific auto-antibodies were all negative.Conclusions The DFS pattern is a common pattern in ANA positivity patients and it mainly exists in non-AID patients.Further more, it is suggested that patients with DFS pattern identified by IIF should then be tested for anti-DFS70 antibodies with a specific immunoassay.
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Objective To explore the prevalence of the anti-saccharomyces cerevisiae antibody (ASCA) in patients with primary biliary cirrhosis and evaluate it's clinical significance. Methods The subtypes of ASCA including IgA and IgG in blood samples from 162 patients with PBC, 44 patients with AIH,4-1 patients with other non-autoimmune liver diseases controls (LDC), 144 patients with inflammatory bowel disease (IBD) and 35 healthy controls were measured by ELISA. Chi-square test and Mann Whitney U test were used for statistical analysis. Results The positive rate of ASCA-IgA in PBC was 24.1%, which was higher than that in ulcerative colitis (UC) group ( 11.6%,χ2=5.5, P＜0.05 ) and healthy controls (0, χ2=10.5,P＜0.01 ). Compared with the AIH group (20.5%) or LDC group ( 14.6% ) or Crohn's disease (CD) (34.5%),there was no statistically significant difference (P＞0.05). The prevalence of ASCA-IgG in PBC was 11.1%,lower than the CD group (27.6%, χ2=8.9, P＜0.01 ), but higher than that in the healthy controls (0, χ2=10.5,P＜0.01 ). There was no statistically significant difference (P＞0.05) between PBC and the AIH group (15.9%)or LDC group (7.3%) or UC group (8.1% ). The positive rate of both ASCA-IgA and ASCA-IgG in PBC was only 6.2%, statistically lower than that of the CD group ( 17.2%, χ2=6.3, P＜0.05). The prevalence of ASCA-IgA or ASCA-IgG in PBC was 29.0%, which was statistically lower than that of the CD group (44.8%, χ2=4.8,P＜0.05), but higher than that of the UC group (χ2=5.9, P＜0.05) or healthy controls (χ2=13.3, P＜0.01).ASCA was detected more frequently in PBC patients with positive anti-GP210 antibody than in anti-GP210 antibody negative PBC patients (38.6% vs 23.8%,χ2=3.9, P＜0.05). The positive rate of ASCA between AMA positive and negative patients with PBC or anti-SP100 antibodies positive and negative patients with PBC was not significantly different. PBC patients with positive ASCA-IgA had higher level of TBIL, DBIL, TBA, LD,IgA, IgM, ESR and lower level of ALB, A/G, CHE than patients with negative ASCA-IgA. There was no statistically significant difference in liver injury indicators and immune function parameters between patients with positive ASCA-IgG and negative ASCA-IgG. Conclusion ASCA is not an IBD-specific antibody. There is a high prevalence of ASCA in patients with PBC, especially the subtype of ASCA-IgA. ASCA-IgA is found to be associated with the severity of liver damage and immune activity whereas ASCA-IgG is not associated with them.