儿童AID与非AID患者血清抗核抗体荧光核型、滴度及特异性抗体检测的诊断价值OA

Objective To explore the clinical significance of antinuclear antibody(ANA)positivity in children,analyze the diag-nostic value of ANA fluorescence patterns,titers,and specific antibody profiles in distinguishing autoimmune diseases(AID)and non-AID in children,and identify independent predictors of AID.Methods A retrospective analysis was conducted on the clinical data of 287 children with ANA positivity(titer≥1:100)who were admitted to the Northwest Women's and Children's Hospital from July 2024 to June 2025.Patients were divided into an AID group(85 cases)and a non-AID group(202 cases)based on the final diagnosis.Differences in ANA fluorescence patterns,titers,and the distribution of 12 specific antibodies were compared be-tween the two groups,and binary Logistic regression analysis was used to identify independent predictors of AID in children.Re-sults Among the 287 ANA-positive children,29.62％were in the AID group and 70.38％were in the non-AID group.The propor-tion of females(71.76％)and the median age[8.00(3.25,10.00)years]in the AID group were significantly higher than those in the non-AID group[53.96％,6.00(2.75,9.00)years](χ2=7.854,Z=-2.246,both P<0.05).The proportion of granular pattern in the AID group(49.41％)was significantly higher than that in the non-AID group(26.73％),while the proportion of dense fine granular pattern(8.24％)was significantly lower than that in the non-AID group(27.23％)(χ2=13.823 and 12.742,both P<0.001).The proportion of high titer(≥1:1 000)in the AID group(11.8％)was significantly higher than that in the non-AID group(0.50％),whereas the non-AID group was predominantly characterized by low titer(1:100)(85.6％)(χ2=21.762,P<0.001).The overall positive rate of specific antibodies in the AID group(45.88％)was significantly higher than that in the non-AID group(11.88％)(χ2=40.369,P<0.001).Logistic regression analysis revealed that female gender(OR=2.364,P=0.012),increasing age(OR=1.095,P=0.019),and positive anti-mitochondrial M2(AMA-M2)antibody(OR=5.118,P=0.004)were inde-pendent risk factors for AID in children,while dense fine-granular karyotype(OR=0.326,P=0.025)was an independent protec-tive factor.Conclusions Positive ANA in children is not equivalent to AID and is often caused by nonspecific reactions such as infection.Low titer(1:100),dense fine-granular pattern,and absence of specific antibodies indicate a low AID risk,while moder-ate-to-high titers(≥1:320),granular or homogeneous patterns,and positive anti-dsDNA,anti-Sm,anti-NUC,and anti-AMA-M2 antibodies indicate a significantly increased AID risk.