摘要目的:探究核周型抗中性粒细胞胞质抗体（pANCA）、抗酿酒酵母抗体（ASCA）、抗胰腺腺泡抗体（PAB）、抗小肠杯状细胞抗体（GAB）在炎症性肠病（IBD）患儿中的阳性率及鉴别诊断价值。方法:纳入2013年1月至2019年6月首都医科大学附属北京儿童医院消化科确诊的199例IBD患儿为研究对象，其中克罗恩病（CD）患儿109例，溃疡性结肠炎（UC）患儿90例。回顾性收集患儿的临床资料及pANCA、ASCA、PAB、GAB检测结果。以疾病诊断作为标准，分别计算4种抗体单独及联合诊断UC和CD的灵敏度、特异度、阳性预测值和阴性预测值。结果:pANCA在UC组的阳性率明显高于CD组（32.22%比18.35%， P<0.05）；ASCA在CD组的阳性率明显高于UC组（27.52%比10.00%， P<0.05）；PAB及GAB阳性率在CD组和UC组之间无显著差异。CD患儿中ASCA诊断灵敏度为27.52%，特异度为90.00%；ASCA +/GAB -、pANCA -/ASCA +和ASCA +/PAB -对CD诊断灵敏度分别为26.61%、22.94%和22.02%，特异度分别为90.00%、95.55%和92.22%。UC患儿中pANCA诊断灵敏度为32.22%，特异度为81.65%，pANCA +/GAB -、pANCA +/ASCA -和pANCA +/PAB -对UC诊断灵敏度分别为31.11%、28.89%和25.56%，特异度分别为81.65%、86.23%和83.49%。其他抗体及组合对CD和UC鉴别诊断的灵敏度及特异度均较低。 结论:pANCA在UC患者中检测阳性率较高；ASCA在CD患者中检测阳性率较高；各抗体单项及组合对CD和UC鉴别诊断的敏感度较低，特异度较高。

abstractsObjective:To investigate the positive rate and the value of differential diagnosis of four serum antibodies, including perinuclear anti-neutrophil cytoplasmic antibody (pANCA) , anti-saccharomyses cerevisiae antibody (ASCA) , antibodies against exocrine pancreas (PAB) and antibodies to intestinal goblet cells (GAB) in pediatric inflammatory bowel disease (IBD) .Methods:A retrospective analysis was performed on 199 IBD patients in Beijing Children′s Hospital of Capital University from January 2013 to June 2019, including 109 cases of Crohn′s disease (CD) and 90 cases of ulcerative colitis (UC) . The data of pANCA, ASCA, GAB, PAB were collected. Taking the clinical diagnosis as standard, the sensitivity, specificity, positive predictive value and negative predictive value of the four antibodies alone and combination for the diagnosis of UC and CD were calculated.Results:The positive rate of pANCA in UC group was obviously higher than that in CD group (32.22% vs. 18.35%, P<0.05) , while the positive rate of ASCA was significantly higher in CD group than that in UC group (27.52% vs. 10.00%, P<0.05) . There were no significant differences in the positive rates of PAB and GAB between CD group and UC group. In CD patients, the diagnostic sensitivity of ASCA was 27.52%, and the specificity was 90.00%; the diagnostic sensitivity of ASCA +/GAB -, pANCA -/ASCA + and ASCA +/PAB - to CD was 26.61%, 22.94%, 22.02%, and the specificity was 90.00%, 95.55% and 92.22%, respectively. In children with UC, the diagnostic sensitivity of pANCA was 32.22%, and the specificity was 81.65%; the diagnostic sensitivity of pANCA +/GAB -, pANCA +/ASCA -, pANCA +/PAB - to UC was 31.11%, 28.89%, 25.56%, and the specificity was 81.65%, 86.23%, and 83.49%, respectively. Other antibodies alone or combinations were not effective in the differential diagnosis of CD and UC (all P<0.05) . Conclusions:Positive rate of pANCA is higher in UC children and positive rate of ASCA is higher in CD children. Each antibody alone or combination has low sensitivity and high specificity in the differential diagnosis of CD and UC.