| Objective:The positive expression of anti-nuclear antibody(ANA)and anti-cyclic citrullinated peptide antibody(A-CCP)in healthy people in southwest China was investigated,and the incidence of autoimmune diseases in healthy people in southwest Chinato was observed,also the impact of autoimmune diseases was analyzed,so that the correlation between ANA and anti-CCP and autoimmune diseases(AID)could be observed,which could provide clinical basis for early diagnosis and prevention of AID.Method:The cross-sectional survey method was used in this paper,while 27276 physical examination populations from January 2016 to June 2017 at the Health Management Department of the Southwest Hospital of the Army Military Medical University was selected as research object,also the cross-sectional study population mainly came from three regions of Sichuan,Chongqing and Guizhou.The general data of 27276 patients were counted,and their names were indicated by physical examination number,in addition,the gender,age,weight,family history,smoking history,drinking history,allergy history,residence,education level,and female menopause status of the patient were recorded.ANA was detected by indirect immunofluorescence,while anti-CCP was determined by enzyme-linked immunosorbent assay(ELISA).345 people who with ANA titer of 1:320 or above and 75 people who with anti-CCP titer of 25 or above were informed to consult rheumatology Immunology Department in the physical examination report,which of them were need further examination.The telephone visit was conducted after 6-9 months of physical examination,so that it could understand the incidence of AID in the above population.In this study,Excel 2013 was used to establish the database file,and the research data were processed by statistical software SPSS22.0,also the data was entered by using the secondary entry method.The sample size,frequency,mean value,standard deviation,etc were described.The counting data were expressed by frequency(rate,constituent ratio),while the comparison of rates was tested by chi-square(2);the measurement data of non-normal distribution were expressed by median and non-parametric rank sum test;the measurement data of normal distribution were expressed by mean(+standard deviation(+S),also the comparison of mean was expressed by t test.The person correlation analysis was used to detect the correlation between ANA and anti-CCP indicators,according to the dependent variable “whether autoimmune disease occurred”,the two-class Logistic regression model was used to analyze the risk factors of autoimmune disease.Result:1.From January 1,2016 to June 2017,27,276 physical examinations were performed by ANA,while 5,089 physical examinations were also tested for ANA and anti-CCP.2.A total of 2727276 cases of ANA were screened,in which of them 3267 cases were positive,345 were titers of 1:320 and above,and those with high titer were 1.26% of the total number of screenings.The positive ANA classification was as follows: 2038 cases were spot type,468 cases were cytoplasm type,345 cases were nucleoli type,271 cases were homogenization type,97 cases were centromere type,and 48 cases were nuclear type.Among them,141 cases were diagnosed as autoimmune diseases,while 31 cases of systemic lupus erythematosus(SLE),which was accounted for 8.99% of the high titer ANA population;33 cases of rheumatoid arthritis(RA),which was accounted for 9.57% of the high titer ANA population;32 cases of mixed connective tissue disease(MCTD),which was accounted for 9.28% of the high titer ANA population;18 cases of autoimmune hepatitis(AIH),which was accounted for 5.22% of the high titer ANA population;27 cases of primary biliary cholangitis(PBC),which was accounted for 7.83% of high titer ANA population.Three of the 31 patients with confirmed systemic lupus erythematosus(SLE)were detected during follow-up,while the remaining 204 patients with high ANA titer were under follow-up.3.From January 1,2016 to June 2017,a total of 5089 anti-CCP antibodies were screened,in which of them 75 cases were positive,and the positive rate was 1.47%.Among them,24 cases were diagnosed as rheumatoid arthritis(RA),which was accounted for 32% of the-CCP positive population.Two of the 24 patients with confirmed rheumatoid arthritis(RA)were detected during follow-up,while the remaining 51 cases anti-CCP positive patients were under follow-up.4.The Pearson correlation analysis showed that there was a significant positive correlation between the incidence of autoimmune diseases and high titer ANA and anti-CCP positive expression(P<0.05).5.Age and education level were not the influencing factors of autoimmune disease(P > 0.05),while gender,BMI,smoking history,diabetes,hyperlipidemia,family history,allergic history,residence,female menopausal status,high titer of ANA and anti-CCP were the influencing factors of autoimmune disease(P < 0.05).6.Female,family history,high titer of ANA and positive anti-CCP were the risk factors of autoimmune diseases.Among them,the incidence of autoimmune diseases in women was 1.963 times that that in men,the incidence of autoimmune diseases in hypertensive patients was 1.586 times that in healthy people,the incidence of autoimmune diseases in those with family history was 2.046 times higher than that in normal people,the incidence of autoimmune diseases in those with high titer of ANA positive patients was 11.985 times higher than that in negative people.Conclusion:1.The risk of AID was high among the high titer ANA positive people in the population of physical examination in Southwest Hospital,especially the long-term morbidity of asymptomatic high titer ANA positive population needed close follow-up.2.The positive rate of anti-CCP was not high in the population of physical examination in Southwest Hospital,but once the RA occurred,it may lead to limb disability,also it would seriously affect the quality of life for patients and brought huge economic burden to the family and society.3.Female,family history,ANA high titer positive and anti-CCP positive could significantly increase the risk of AID.4.ANA high titer positive and anti-CCP positive expression were positively correlated with the occurrence of AID.The screening and follow-up of ANA and anti-CCP in the population of physical examination were conducted,while there were great significance for the early detection,early diagnosis and early treatment for AID,it would be possible to avoid great disease damage that caused by AID. |
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