抗核抗体组

定义

The antinuclear antibody panel is a blood test that looks at antinuclear 抗体 (ANA).

• ANA are 抗体 produced by the immune system that bind to the body's own tissues.
• The antinuclear antibody test looks for 抗体 that bind to a part of the cell called the nucleus.

If the test is positive, a panel of tests may be done to identify specific 抗体. 这是ANA抗体面板.

选择的名字

ANA; ANA panel; ANA reflexive panel; SLE - ANA; Systemic lupus erythematosus - ANA

如何执行测试

血液从静脉中抽取. Most often, a vein on the inside of the elbow or the back of the hand is used. The site is cleaned with germ-killing medicine (antiseptic). The health care provider wraps an elastic band around the upper arm to apply pressure to the area and make the vein swell with blood.

Next, the provider gently inserts a needle into the vein. The blood collects into an airtight vial or tube attached to the needle. 松紧带从你的手臂上取下了.

一旦采集了血液, 针头被取出, and the puncture site is covered to stop any bleeding.

用于婴儿或幼童, a sharp tool called a lancet may be used to puncture the skin and make it bleed. The blood collects into a small glass tube called a pipette, or onto a slide or test strip. A bandage may be placed over the area if there is any bleeding.

Depending on the laboratory, the test may be processed in different ways. One method requires a technician to examine a blood sample under a microscope using ultraviolet light. The other uses an automated instrument to record the results.

如何准备考试

不需要特别准备. 然而, 某些药物, 包括避孕药, 普鲁卡因胺, 还有噻嗪类利尿剂, 影响这个测试的准确性. Make sure your provider knows about all the medicines you take.

考试的感觉如何

When the needle is inserted to draw blood, some people feel moderate pain. Others may feel only a prick or stinging sensation. 之后，可能会有一些悸动.

为什么要进行测试

You may need this test if you have signs of an autoimmune disorder, 比如无法解释的症状包括 关节炎皮疹、发烧或胸痛. 怀疑 系统性红斑狼疮 may be the most common reason why the test is done.

正常的结果

ANA test results are most often reported in 2 parts: the level or titer and the pattern.

• Titres are reported in ratios, most often 1:40, 1:80, 1:160, 1:320, and 1:640. Some, but not all labs will report a titre above 1:160 as positive.
• Patterns that are reported include, homogeneous, speckled, centromere, and others.

Normal value ranges may vary slightly among different laboratories. Talk to your provider about the meaning of your specific test results.

The examples above show the common measurements for results for these tests. Some laboratories use different measurements or may test different specimens.

Further tests can be run on blood with a positive ANA test to get more information.

异常结果意味着什么

ANA阳性并不足以做出诊断. To diagnose any disease related to a positive ANA, it is important to have:

• A full assessment by a doctor who specializes in any of the illnesses listed below
• 进一步的抗体测试，针对某些疾病

To make the diagnosis of SLE, the following must be present

• 某些临床特征
• Positive ANA results (a lack of ANA makes the diagnosis much less likely)
• Certain specific ANA 抗体, which help to confirm the diagnosis

Other disorders besides SLE where positive ANA results strongly suggest a diagnosis include:

• 系统性硬化症(硬皮病)
• Sjögren综合征(原发性)
• 肌炎(炎症性肌肉疾病)
• 药物性红斑狼疮

Other common diseases that ANA testing can help diagnose include:

• 混合性结缔组织病
• 多发性肌炎/皮肌炎
• 自身免疫性肝炎
• EB病毒
• 丙型肝炎
• 艾滋病毒
• 淋巴瘤
• 类风湿性关节炎
• 甲状腺疾病
• 细小病毒

风险

Veins and arteries vary in size from one person to another, 从身体的一边到另一边. Obtaining blood from some people may be more difficult than from others.

Other risks associated with having blood drawn are slight, but may include:

• 大出血
• 昏厥或感到头晕
• 血肿(皮肤下积血)
• Infection (a slight risk any time the skin is broken)

注意事项

The ANA can be positive in relatives of people with SLE who do not have SLE themselves.

There is a very low chance of developing SLE at some time later in life if the only finding is a low titer of ANA.

参考文献

美国风湿病学会网站. 抗核抗体(ANA). www.风湿病学.org/patients/antinuclear-抗体-ana. 2023年2月更新. 2023年10月3日发布.

Peng SL, Craft JE. 反核抗体. In: Firestein GS, Budd RC, Gabriel SE, Koretzky GA, McInnes IB, O'Dell JR, eds. Firestein & 凯利风湿病学教科书. 11日艾德. Philadelphia, PA: Elsevier; 2021:chap 58.

von Mühlen AC, Chan EKL, Ceribelli A, Fritzler MJ. Clinical and laboratory evaluation of systemic autoimmune rheumatic diseases. 见:McPherson RA, Pincus MR，编辑. Henry's Clinical Diagnosis and Management by Laboratory Methods. 24日艾德. Philadelphia, PA: Elsevier; 2022:chap 53.