Objective To clarify the differences of clinical manifestations in patients of Churg Strauss syndrome （CSS） with or without antineutrophil cytoplasmic antibody （ANCA） positive，and primarily explore the roles of ANCA and eosinophilia in CSS according to current literatures. Methods The clinical data of 25 patients with CSS，admitted to Peking Union Medical College Hospital from January 2001 to November 2010，were retrospectively investigated. Results The positive rate of ANCA in Churg Strauss was 32.0%，with P-ANCA predominantly （in 6 patients）. The lung involvement in the patients between ANCA positive and ANCA negative patients was 16.7% and 82.4% respectively with significant difference. The heart involvement in the patients between ANCA positive and ANCA negative patients were 60.0% and 64.2%，respectively.The peripheral neuropathy between ANCA positive and ANCA negative patients were 85.7% and 66.7%，respectively.The renal manifestations between ANCA positive and ANCA negative patients were 75.0% and 35.3%，respectively. But the differences in heart，peripheral neuropathy，orrenal manifestations were not significant. Conclusion The status of ANCA may represent different clinical phenotype of CSS.
目的 探讨酶联免疫吸附试验(ELISA)检测血清甲胎蛋白异质体(AFP-L3)含量对原发性肝癌（PLC）的诊断价值。 方法 选择2011年3月－11月门诊或住院的137例患者临床检测甲胎蛋白(AFP)为阳性的肝病患者血清，应用上海逸峰生物科技有限公司提供的ELISA法AFP-L3检测试剂盒检测AFP-L3浓度，137例中男98例，女39例，年龄28～77岁。其中PLC 92例，良性肝病45例，后者包括肝硬化37例、慢性肝炎8例。分析PLC组与良性肝病组AFP-L3浓度差异，运用受试者工作特征曲线(ROC)分析AFP-L3含量在PLC鉴别诊断中的价值。 结果 PLC组AFP-L3浓度[（109.04 ± 62.51）ng/mL]明显高于良性肝病组[（25.96 ± 49.43）ng/mL，两组差异有统计学意义（t=8.28 ，P＜0.001）。ROC分析结果显示，曲线下面积为0.819，以AFP-L3浓度37.89 ng/mL为临界值，分析92例PLC患者与45例良性肝病患者AFP-L3浓度异常的灵敏度为83.69%，特异度为88.88%，阳性预测值为93.90%（77/82），阴性预测值为72.72%（40/55），诊断准确度为85.40%。 结论 应用简便快速的ELISA法检测AFP-L3浓度在PLC与良性肝病鉴别诊断中具有较高的临床价值，便于临床推广。