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 探討酶聯免疫吸附試驗(ELISA)檢測血清甲胎蛋白異質體(AFP-L3)含量對原發性肝癌（PLC）的診斷價值。 方法 選擇2011年3月－11月門診或住院的137例患者臨床檢測甲胎蛋白(AFP)為陽性的肝病患者血清，應用上海逸峰生物科技有限公司提供的ELISA法AFP-L3檢測試劑盒檢測AFP-L3濃度，137例中男98例，女39例，年齡28～77歲。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組與良性肝病組AFP-L3濃度差異，運用受試者工作特征曲線(ROC)分析AFP-L3含量在PLC鑒別診斷中的價值。 結果 PLC組AFP-L3濃度[（109.04 ± 62.51）ng/mL]明顯高于良性肝病組[（25.96 ± 49.43）ng/mL，兩組差異有統計學意義（t=8.28 ，P＜0.001）。ROC分析結果顯示，曲線下面積為0.819，以AFP-L3濃度37.89 ng/mL為臨界值，分析92例PLC患者與45例良性肝病患者AFP-L3濃度異常的靈敏度為83.69%，特異度為88.88%，陽性預測值為93.90%（77/82），陰性預測值為72.72%（40/55），診斷準確度為85.40%。 結論 應用簡便快速的ELISA法檢測AFP-L3濃度在PLC與良性肝病鑒別診斷中具有較高的臨床價值，便于臨床推廣。