The Foundation Of The Antiperinuclear Factor's Detection And Its Clinical Significance

Objective: This experiment discussed the regularity of substrate's antigen which detected the antiperinuclear factor by analyzing the person's sex and connective tissue disease, then chose the suitable person and make the antigenic plate. We detected the positive rate in the early diagnosis of rheumatoid arthritis (RA) the typical RA miscellaneous rheumatic diseases and the healthy individual with it. Analyzed the diagnostic value of APF in RA especially in the early RA by this result . Simultaneously we detected the antikerarin antibody (AKA) rheumatoid factor(RF) and the inflammatory markers such as hyaluronate (HA) erythrocyte sedimentation rate(ESR) c-reactive protein (CRP) in this four group of person ,to analyze the correlation among APF AKA and RF, discuss the significance of three antibody's detection in the diagnosis of RA. To made further analysis for the relation between APF and the severity of RA.Method:(l)The choice of APF substrate: firstly, divided into groups by sex in 76 healthy donors of buccal mucosa cells, made the antigenic plate, made analysis with chi-square test by the standard of APF's positive serum secondly, divided into groups by CTD in other 76 donors , made the sameanalysis .To discuss the influence of sex and CTD to substrate . (2) Chose 120 experimental objections ,divided into four groups: experimental standard group(A group: The typical RA patients whose durations were more than one year) non-standard group(B group: Their durations were no more than one year or we only suspected that they had RA but we could not confirm it. And they had no bone erosion in X radiograph) > non RA control(C group: other connective tissue disease except RA) and the healthy control group (D group) after detecting their function of liver and keeping their result normal. For A and B group, antinuclear antibody was measured with indirect immunofluorescence(IIF) ;extractable nuclear antibody was measured with immunoblot. Then detected APF and AKA with IIF. detected RF, CRP with the latex agglutination assay , detected HA with radio-immunoassay. At the same time we wrote down the ESR (3)Analyzed the APF's sensitivity and specificity for RA by the APF's positive rate in four groups. (4) Compared the serum level of HA in four group's with analysis of variance. (5)Correlations among APF AKA RF and the inflammatory index (including HA ESR CRP)in serum were obtained using spearman's correlation method.Result :(1) There were 38 positive person in the 76 healthy donors of substrate; female was 42 person (including 23 positive donors, 19 negative donors); male was 34 person (including 15 positive donors,19 negative donors). Therewere no significant difference (p>0.05) with chi-squaretest. As far as CTD was concerned, there were 39 CTD patients (including 22 positive donors, 17 negative donors);there were 37 healthy donors(including 17 positive donors, 20 negative donors) in the last 76 donors. There was no significant difference (p>0.05) with chi-square test. There were eight donors whose relation were parents and children in the last 76 donors, their results was consistent, six donors were all positive ,two donors were negative; In addition ,the more scraping deeply ,the more adding positive cells. (2)At the titer of l:20,the APF's positive person in four groups is: 19 positive patients in A group;22 positive patients in B group;! positive person in both C and D group. Their positive rate is 63.3 percent in A group;73.3 percent in B group;3.3 percent in C and D group. When 1:80 were taken as positive titer, both C and D group were all negative. (3)The serum level of HA in four groups :A group is 135.39+100.14ng/ml; B group is 167.11+119.45ng/ml; C group is 104.94164.63ng/ml; D group is 66.60+29.15ng/ml. We use the analysis of variance to compare, then found that there were significant difference in A and D group B and D group; but no significant difference in A and B group, A and C group B and C group C and D group. (4) APF was highly correlated with RF (the correlation coefficient was 0.385,P<0.