本文選題：克羅恩病　切入點(diǎn)：潰瘍性結(jié)腸炎　出處：《浙江大學(xué)》2014年碩士論文　論文類型：學(xué)位論文

【摘要】：目的：探討5種抗聚糖抗體分別及聯(lián)合測(cè)定對(duì)克羅恩病診斷的價(jià)值。 方法：該研究對(duì)IBD患者及對(duì)照組進(jìn)行了臨床數(shù)據(jù)和生化結(jié)果的分析,研究對(duì)象選取選取2013年1月至2014年4月在本院消化內(nèi)科門診及住院患者。IBD患者111例：潰瘍性結(jié)腸炎41例,克羅恩病70例,并根據(jù)維也納分型標(biāo)準(zhǔn)對(duì)CD患者進(jìn)行分組,疾病對(duì)照組患者46例,健康對(duì)照組28例。抗體測(cè)定采用間接酶聯(lián)免疫吸附技術(shù),數(shù)據(jù)分析運(yùn)用統(tǒng)計(jì)軟件SPSS18.0, P0.05認(rèn)為有統(tǒng)計(jì)學(xué)差異。 結(jié)果：本實(shí)驗(yàn)中,結(jié)果最好的為抗體AMCAIgG. AMCAIgG在CD患者組中的陽性率明顯高于其他各組的陽性率(P0.01),在CD患者中其敏感性高達(dá)45.7%,與各組相比特異性達(dá)92-95%。ASCA IgG的結(jié)果較好,在CD患者組中的陽性率明顯高于其他3組,(P0.05),在CD患者中的陽性率為18.6%,與各組相比特異性均達(dá)95%以上。接下來依次為ASCAIgA, ALCAIgG, ACCAIgA。聯(lián)合測(cè)定時(shí),5種聯(lián)合方式均能鑒別CD組與其他3個(gè)對(duì)照組。其敏感性及特異性差異較大。組合1(5種抗體中至少1種陽性)：敏感性75.7%,特異性在65-80%之間。組合2(5種抗體中至少2種陽性)：敏感性為40%,特異性在80-90%之間。組合3(ASCAIgG, ASCAIgA, AMCA, ALCA4種抗體至少1種陽性)：敏感性高,達(dá)72.9%,特異性偏低,在70-85%之間。組合4(ASCAIgG, AMCA2種抗體中1種陽性,或其他3種抗體中至少2種陽性。)：敏感性60%,特異性在78-90%之間。組合5(ASCA IgG, AMCA2種抗體中1種陽性。)：敏感性達(dá)54.3%,特異性在87-95%之間。 結(jié)論：5種抗聚糖抗體對(duì)于IBD的診斷及鑒別診斷均有一定的意義,其中UMCAIgG及ASCAIgG對(duì)CD的診斷意義最大,接下來依次為ASCAIgA, ALCAIgG, ACCA IgA。本實(shí)驗(yàn)中組合4(ASCAIgG, AMCA2種抗體中至少1種陽性,或其他3種抗體中至少2種陽性)及組合5的聯(lián)合方式(ASCAIgG, AMCA2種抗體中至少1種陽性)對(duì)CD的診斷作用較好。
[Abstract]:Objective: to evaluate the value of five anti-glycan antibodies in diagnosis of Crohn's disease. Methods: the clinical data and biochemical results of the patients with IBD and the control group were analyzed. The subjects were selected from January 2013 to April 2014 in the Department of Digestive Medicine and the inpatient of our hospital: 41 patients with ulcerative colitis, 41 patients with ulcerative colitis, 41 patients with ulcerative colitis, 41 patients with ulcerative colitis from January 2013 to April 2014. Seventy patients with Crohn's disease were divided into two groups according to the Vienna classification criteria: 46 patients in the disease control group and 28 in the healthy control group. Indirect enzyme-linked immunosorbent assay (Elisa) was used for the determination of antibodies. Statistical software SPSS 18.0 was used for data analysis. Results: in this experiment, the best result was that the positive rate of AMCAIgG in CD group was significantly higher than that in other groups (P 0.01), and the sensitivity was as high as 45.7 in CD patients, and the specificity was 92-95.ASCA IgG. The positive rate in CD group was significantly higher than that in the other three groups (P 0.05), and the positive rate in CD patients was 18.6, and the specificity was over 95% compared with each group. The next order was ASCA IgA, ALCA IgG, ACCA IgA. The sensitivity and specificity of these antibodies were significantly different from those of the other three control groups. The sensitivity was 75.75.75%, the specificity was 65-80%, and the sensitivity was 40%, and the specificity was between 65% and 80%. The sensitivity was 40% and the specificity was 40%. In the range of 80-90%. Combination of 3 AGC, ASCA IgA, AMCA, ALCA4 antibodies at least one positive: high sensitivity, Up to 72.9%, the specificity was low, between 70-85%. Or at least 2 of the other three antibodies: sensitivity is 60, specificity is between 78 and 90%. Combination of 5 ASCA IgG, 1 positive in AMCA2 antibody: sensitivity is 54.3%, specificity is between 87 and 95%. Conclusion five kinds of anti-glycan antibodies are of significance for the diagnosis and differential diagnosis of IBD, among which UMCAIgG and ASCAIgG have the greatest significance in the diagnosis of CD, followed by ASCA IgA, ALCA IgG, ACCA IgA. Or at least 2 of the other 3 antibodies) and combination 5 combined with ASCAIgG and at least one of the AMCA2 antibodies were better in the diagnosis of CD.
【學(xué)位授予單位】：浙江大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：R574

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