Cov tshuaj tiv thaiv rau cov tshuaj tiv thaiv nuclear, lossis ANA, yog ib pawg neeg sib txawv ntawm autoantibodies uas tau hais tawm tsam cov ntsiab lus ntawm lawv tus kheej nuclei. Lawv raug kuaj pom tias yog tus cim ntawm cov kab mob ntawm hom autoimmune thiab txiav txim siab los tsim kev kuaj mob, ntsuas kev ua haujlwm ntawm pathology thiab tswj kev kho mob.
Raws li ib feem ntawm txoj kev tshawb fawb, cov tshuaj tiv thaiv ntawm cov chav kawm xws li IgM, IgA, IgG raug kuaj pom.
Study overview
ANA, lossis cov tshuaj tiv thaiv rau cov tshuaj tiv thaiv nuclear, yog ib feem ntawm pawg neeg sib txawv ntawm autoantibodies uas tau coj tawm tsam cov ntsiab lus ntawm lawv tus kheej nuclei. Lawv tau txiav txim siab hauv cov ntshav ntawm cov neeg mob uas muaj qee yam kab mob autoimmune, piv txwv li, cov kab mob sib txuas ntawm cov ntaub so ntswg, thawj kab mob cirrhosis, autoimmune pancreatitis, thiab ntau yam mob neoplasms. Kev tsom xam rau cov tshuaj tiv thaiv kab mob rau cov tub ntxhais antigen ntawm ANA cov kab mob yog siv los kuaj xyuas cov kab mob autoimmune hauv cov neeg mob uas muaj cov tsos mob ntawm tus txheej txheem autoimmune (tsis paub meej.los ntawm keeb kwm, ua npaws ntev, tawv nqaij pob, tsis muaj zog, articular syndrome, thiab lwm yam).
Cov neeg mob zoo li no xav tau cov txiaj ntsig zoo rau kev kuaj mob ntxiv, suav nrog kev kuaj tshwj xeeb ntxiv rau txhua tus kab mob autoimmune (xws li, anti-Scl-70 yog tias xav tias muaj kab mob scleroderma, cov tshuaj tiv thaiv mitochondria yog cov kab mob biliary thawj cirrhosis). Tsis tas yuav hais, qhov kev ntsuas tsis zoo tsis txiav txim siab qhov muaj tus kab mob autoimmune.
Cov tshuaj tiv thaiv rau cov tshuaj tiv thaiv nuclear raug txiav txim siab hauv cov neeg noj qab haus huv (3-5%), tab sis yog tias cov neeg mob muaj hnub nyoog tshaj 65 xyoo, daim duab no nce mus txog qhov txiaj ntsig ntawm 10 mus rau 37%. Hauv tus neeg mob uas tsis muaj pov thawj ntawm tus txheej txheem autoimmune, qhov txiaj ntsig zoo yuav tsum raug txhais raws li kev kuaj mob ntxiv, cov ntaub ntawv kho mob, thiab keeb kwm.
Lub Hom Phiaj ntawm Kev Kawm
Tshawb nrhiav cov tshuaj tiv thaiv rau cov tshuaj tiv thaiv nuclear yog siv rau lub hom phiaj tshwj xeeb:
- Raws li kev tshuaj ntsuam rau autoimmune pathologies, xws li kab mob sib kis kab mob, thawj kab mob cirrhosis, autoimmune kab mob siab, thiab lwm yam.
- Kev kuaj mob ntawm cov tshuaj tiv thaiv kab mob lupus.
- Rau qhov kev kuaj mob ntawm lub cev lupus erythematosus, kev kuaj mob, kev soj ntsuam ntawm cov kab mob thiab kev tswj hwm nws txoj kev kho.
Cov lus qhia rau cov tshuaj
Ib txoj kev tshawb fawb tau muab rau cov cim hauv qab no ntawm tus txheej txheem autoimmune:
- ua npaws ntev tsis paub keeb kwm, mob pob qij txha, pob khaus tawv nqaij, qaug zog tsis tsim nyog;
- rau cov cim qhia ntawm lupus erythematosus (mob ntawm daim tawv nqaij, ua npaws), mob caj dab / mob caj dab, kab mob raum, mob vwm, pericarditis, pneumonitis;
- txhua rau rau lub hlis lossis ntau zaus thaum ntsuas tus neeg kuaj mob SLE;
- if Hydralazine, Propafenone, Disopyramide, Procainamide thiab lwm yam tshuaj uas cuam tshuam nrog kev txhim kho ntawm cov tshuaj lupus raug tshuaj.
Ntau zaus ntes cov tshuaj tiv thaiv rau cov tshuaj tiv thaiv nuclear ntawm tus kab mob Epstein-Barr.
Hloov Cov Cai
Tshuaj ntsuam cov khoom siv lom neeg: tus neeg mob cov ntshav. Kev npaj tshwj xeeb rau kev tshuaj xyuas tsis tas yuav tsum tau, tab sis koj yuav tsum paub seb tus neeg mob puas haus cov tshuaj uas tuaj yeem cuam tshuam cov txiaj ntsig ntawm kev tshuaj xyuas. Ntawm lawv: Pennicillamine, Tocainide, Nitrofurantoin, Methyldopa, Nifedipine, Lovastatin, Carbamazepine, Hydralazine, β-blockers.
Yog tias siv cov tshuaj no tau sau tseg, nws yuav tsum tau sau tseg hauv daim ntawv kawm.
Txoj Kev
Ntawm cov txheej txheem niaj hnub tshaj plaws ntawm kev tshuaj xyuas ntawm cov tshuaj tiv thaiv kab mob antinuclear sawv tawm ntawm txoj kev enzyme immunoassay lossis ELISA. Antinuclear lub cev nrog nws tau kuaj pom siv cov antigens tshwj xeeb, uas tau kho ntawm cov khoom sib txawv.
Kev tshuaj xyuas ntawm cov tshuaj tiv thaiv kab mob antinuclear los ntawm cov txheej txheem ntawm kev tiv thaiv kab mob tsis ncaj rau ntawm tes txhais tau tias yogCov ntaub ntawv ntau dua li qhov ntsuas ELISA rau cov tshuaj tiv thaiv nuclear. Nws cov txiaj ntsig yog ob qho tib si kom paub meej tias muaj cov tshuaj tiv thaiv kab mob antinuclear thiab txiav txim siab qhov kawg tshuaj tiv thaiv kab mob titer, thiab lwm yam, los piav qhia txog cov yam ntxwv ntawm luminescence ntawm cov tshuaj tiv thaiv kab mob, ncaj qha ntsig txog hom ntawm cov antigens nuclear tiv thaiv uas tom kawg yog. directed.
Txoj kev tshawb fawb tau tshwm sim
Reference qhov tseem ceeb ntawm kev tsom xam rau cov tshuaj tiv thaiv rau ANA core antigens: tsis zoo. Qhov txiaj ntsig zoo tuaj yeem yog vim li cas hauv qab no:
- autoimmune pancreatitis;
- Ysystemic lupus erythematosus;
- malignant neoplasms ntawm lub ntsws thiab daim siab;
- autoimmune thyroid kab mob;
- dermatomyositis/polymyositis;
- sib xyaw cov ntaub so ntswg pathology;
- autoimmune kab mob siab;
- myasthenia gravis;
- Raynaud's syndrome;
- interstitial diffuse fibrosis;
- Sjögren's syndrome;
- Ysystemic scleroderma;
- mob caj dab rheumatoid;
- siv cov tshuaj xws li Propafenone, Disopyramide, Procainamide, qee yam ACE inhibitors, Hydralazine, beta-blockers, Chlorpromazine, Propylthiouracil, Simvastatin, Lovastatin, Hydrochlorothiazide, Minocycline, Isoniazid, Phenamaytoin, Carbide.
Yog vim li cas rau qhov kev xeem tsis zoo: qhov qub lossis txawv txav thaum noj cov khoom lom.
Cov tshuaj tiv thaiv rau Epstein-Barr nuclear antigen
Tus kab mob Epstein-Barr, uas yog ib feem ntawm hom 4 pawg kab mob herpes, tuaj yeem ua rau kis kab mob.mononucleosis. Thiab cov txheej txheem rau kev kuaj mob nws muaj yog cov tshuaj tiv thaiv rau lub nuclear antigen ntawm tus kab mob no IgG (quantitative method, anti-EBNA IgG).
Qhia txog IgG cov tshuaj tiv thaiv kab mob uas qhia tau tias muaj tus kab mob uas tus neeg mob tau muaj. Cov lus qhia tseem ceeb rau kev siv: kuaj cov kab mob cuam tshuam nrog tus kab mob Epstein-Barr (oncological pathologies, kab mob ntev).
Cov tshuaj tiv thaiv rau cov tshuaj tiv thaiv nuclear ntawm Epstein-Barr tus kab mob IgG chav kawm feem ntau kuaj pom hauv cov ntshav hauv lub sijhawm ntawm peb mus rau kaum ob lub hlis tom qab kis kab mob (kwv yees li 4-6 lub hlis), uas yog, nyob rau theem kawg. tom qab kis tau tus kab mob thiab ntev (txog li ob peb xyoos) lawv tuaj yeem kuaj pom tom qab muaj mob. Qhov concentration ntawm cov tshuaj tiv thaiv tau nce thaum lub sijhawm rov qab los. Yog tias tsis muaj cov tshuaj tiv thaiv kab mob rau cov tshuaj tiv thaiv zoo li no hauv kev tshawb pom cov tshuaj tiv thaiv kab mob rau capsid protein (anti-VCA IgM) ntawm tus kab mob Epstein-Barr, qhov no feem ntau qhia tau tias muaj tus kab mob tsis tu ncua.
Ntshav tom qab venipuncture raug coj mus rau hauv lub raj khoob kom tau cov ntshav. Qhov chaw ntawm venipuncture yog nias cia nrog paj rwb wool dov rau hauv ib lub pob kom txog thaum los ntshav nres. Yog hais tias hematoma tau tsim ntawm qhov chaw venipuncture, sov compresses raug tshuaj.
Qhov tshwm sim tsis zoo - los ntawm 0 txog 16 0U / ml. Doubtful - los ntawm 16 mus rau 22. Zoo - tshaj 22 0U/ml.
Thaum sib txawv ntawm cov txiaj ntsig ib txwm, qhov txiaj ntsig zoo txhais tau tias:
- Tus kab mob Epstein-Barr tus kab mob (nrhiav cov tshuaj tiv thaiv lig);
- loj hlob mus rauDaim ntawv mob ntev ntawm tus kab mob los yog theem ntawm tus kab mob reactivation.
Ib qho txiaj ntsig tsis zoo qhia cov hauv qab no:
- thaum ntxov ntawm tus kab mob (txo cov tshuaj tiv thaiv kab mob titer);
- tsis muaj tus kab mob Epstein-Barr.
kab mob siab B
Cov lus qhia rau kev tshawb fawb: kuaj kab mob siab B, yav dhau los pauv lossis saib xyuas qhov xwm txheej ntawm kab mob.
Kev Tshawb Fawb: chemiluminescent method.
Reference tus nqi: tsis zoo.
Antibody rau cov tub ntxhais antigen ntawm kab mob siab B yog tsim tawm. Raws li qhov no, cov hauv qab no yog qhov txawv: anti-HBs nto antibodies (rau HBsAg antigens uas tsim lub hnab ntawv ntawm tus kab mob); anti-HBc nuclear antibodies (rau HBc antigen pom nyob rau hauv cov core protein ntawm tus kab mob).
Tsis yog tshuaj tiv thaiv kab mob hauv cov ntshav ib txwm qhia tias muaj tus kab mob siab B lossis kab mob kho ua ntej. Lawv cov kev tsim tawm kuj tuaj yeem yog qhov tshwm sim ntawm cov tshuaj tiv thaiv. Ntawm lwm yam, lub ntsiab lus ntawm cov cim tuaj yeem ua raws li:
- ua haujlwm tsis zoo ntawm lub cev tiv thaiv kab mob (nrog rau kev loj hlob ntawm cov kab mob autoimmune);
- malignant qog;
- lwm yam kis kab mob.
Cov txiaj ntsig no hu ua qhov tsis zoo, vim tias muaj cov tshuaj tiv thaiv kab mob tsis ua rau muaj kab mob siab B.
Yam dab tsi tuaj yeem cuam tshuam qhov tshwm sim
Uraemia tuaj yeem ua rau qhov tsis zoo tsis raug. Ntau yam tshuaj muaj feem xyuam nrog cov txheej txheemkev loj hlob ntawm cov tshuaj-induced lupus nyob rau hauv lub cev, nrog rau cov tsos ntawm ANA nyob rau hauv cov ntshav.
Cov ntsiab lus tseem ceeb ntawm lub ncauj lus no
Nyob hauv tus neeg mob uas muaj cov tsos mob ntawm tus txheej txheem autoimmune, qhov tshwm sim tsis zoo yuav tsis txiav txim siab txog qhov muaj tus kab mob autoimmune.
ANA tau txiav txim siab hauv cov neeg noj qab haus huv (3 txog 5%) thiab hauv cov neeg laus tom qab 65 xyoo (10 txog 37%).
Yog tias tus neeg mob tau txais txiaj ntsig zoo yam tsis muaj qhov tshwm sim ntawm tus txheej txheem autoimmune, nws yuav tsum tau txhais, suav nrog kev kuaj mob ntxiv, cov ntaub ntawv kho mob thiab cov tshuaj anamnestic (cov neeg zoo li no muaj 40 npaug ntau dua yuav muaj SLE).
