【摘要】 目的研究天疱疮患者血清中抗桥粒芯蛋白(desmoglein,Dsg)1和抗Dsg3抗体水平在天疱疮的临床诊断价值。方法采用酶联免疫吸附试验(ELISA)测定62例天疱疮患者血清中抗Dsg1和抗Dsg3抗体水平;间接免疫荧光法(IIF)测定天疱疮抗体Ig G水平。结果 62例天疱疮患者中抗Dsg1抗体或抗Dsg3抗体任一阳性共50例,阳性率80.65%,与间接免疫荧光法(IIF)相比两种方法差异无统计学意义(P>0.05)。因此抗Dsg抗体具有和IIF一样的临床诊断价值。34例寻常型天疱疮(PV)中抗Dsg3抗体阳性或抗Dsg1和抗Dsg3抗体均阳的28例,阳性率82.35%;24例落叶型天疱疮(PF)中抗Dsg1抗体阳性的为20例,阳性率83.33%。可见抗Dsg3抗体是PV的鉴别诊断指标,抗Dsg1抗体是PF的鉴别诊断指标。此外,通过对治疗前后抗Dsg1抗和Dsg3抗体的滴度水平的检测发现,抗Dsg1和抗Dsg3抗体还可作为天疱疮治疗监测的指标。结论采用ELISA方法测定天疱疮患者外周血抗Dsg1抗体和抗Dsg3抗体,方法简便,对患者创伤小,有一定的诊断和鉴别诊断价值。另外,抗Dsg1抗体和抗Dsg3抗体还可作为监测天疱疮治疗效果的指标。更多还原

【Abstract】 Objective To study the clinical diagnostic value of anti-desmoglein( Dsg) 1 and anti-Dsg3 antibody levels in pemphigus. Methods Serum anti-Dsg1 and anti-Dsg3 antibody levels were measured by Enzyme-linked immunosorbent assay( ELISA) in 62 patients with pemphigus. Indirect immunofluorescence assay( ll F) was used to measure Ig G levels in patients with pemphigus. Results Either anti-Dsg1 or anti-Dsg3 antibody was positive in 50 of 62 cases with pemphigus. The positive ratio was 80. 65%. There was no significant difference( χ2= 0. 06,P > 0. 05) compared with the method of IIF. The anti-Dsg antibody showed the same clinical diagnostic value as IIF. A total of 28 in 34 cases of pemphigus vulgaris were positive in antiDsg3 antibody or both anti-Dsg1 and anti-Dsg3 antibody and the positive ratio was 82. 35%. A total of 20 in24 cases of pemphigus foliaceus were positive in anti-Dsg1 antibody and the positive ratio was 83. 33%. Anti-Dsg3 was a visible indicator for the differential diagnosis of PV and anti-Dsg1 antibody was an index on the differential diagnosis of PF. In addition,anti-Dsg1 and anti-Dsg3 antibody could be used as the monitoring indicators of pemphigus treatment by monitoring the anti-Dsg1 and anti-Dsg3 antibody level before and after treatment. Conclusion Anti-Dsg1 antibody and anti-Dsg3 antibody in peripheral blood of patients with pemphigus could be measured by the method of ELISA. This method was simple,less traumatic to the patient and it showed certain value on both diagnosis and differential diagnosis of pemphigus. In addition,antiDsg1 and anti-Dsg3 antibody could be used as the monitoring indicators of pemphigus treatment.更多还原