新型自身抗体SP1对原发性干燥综合征诊断的意义

发布时间：2018-05-19 21:05

  本文选题：原发性干燥综合征 + 抗SP1抗体　； 参考：《福建中医药大学》2015年硕士论文

【摘要】：目的：Salivary gland protein 1(SP1)蛋白是干燥综合征(SS)患者涎腺中新发现的自身抗原。本研究为国内首次通过免疫印迹法检测汉族原发性干燥综合征(pSS)血清中抗SP1抗体表达水平,探索该抗体在该疾病诊断及早期诊断的意义,并分析其与疾病活动度、各脏器受累和实验室指标的关系。方法：连续收集119例厦门大学附属第一医院风湿免疫科及眼科确诊为pSS汉族患者和50例无SS的类风湿关节炎(RA)患者,并招募50名健康为健康对照组。其中pSS分为：A组(SSA- and SSB-:n=23);B组(SSA+ or SSB+:n=49);C组(SSA+ and SSB+: n=47)。运用免疫印迹法(Westernblot)检测各组抗SP1抗体的表达情况,并分析其与pSS患者疾病活动度、唇腺组织活检病理分级、脏器受累及免疫学指标、炎症指标的关系。结果：1、免疫印迹法检测各组中抗SP1抗体：在119例汉族pSS患者的阳性率为39.5%,显著高于RA组22%(P=0.029)及健康对照组10%(***P0.0001),且其特异性为84%,但明显高于抗ANA抗体。2、抗SP1抗体与SSA、SSB两两联合检测或3种抗体联合检测互为补充,明显高于单一抗体的阳性率,其中以3种抗体联合检测阳性率最高,达88.2%。3、pSS各亚组的阳性率情况：A组(SSA- and SSB-:n=23):39.1%:B组(SSA+ or SSB+: n=49):55%;C组SSA、SSB均阳性组(SSA+ and SSB+:n=47):23%,且A组与健康对照组具有明显统计学差异(***P=0.001)。4、抗SP1抗体阳性组(n=47)与SP1阴性组(n=72)的ESSDAI无明显差异,但抗SP1抗体阳性的患者明显集中分布在ESSDAI≤2中。5、发现抗SP1抗体阳性的pSS患者组平均病程为2.5(±1.7)年,明显短于抗体阴性的患者组平均病程为3.68(±2.8)年,具有统计学差异(*P=0.044),且阳性组唇腺组织Chisholm等级均较低,以A组最为明显,均≤Ⅲ级。6、抗体阳性患者的淋巴组织及腺体组织受累较抗体阴性组明显增高,具有统计学差异(*P=0.02),但与免疫球蛋白(IgG)、补体(C3)、类风湿因子(RF)、抗抗环瓜氨酸抗体(CCP)、C反应蛋白(CRP)等指标无明显统计学差异。结论：本研究为首次检测汉族pSS患者抗SP1抗体的表达情况,结果表明抗SP1抗体是pSS较特异性的自身抗体之一,联合抗SSA、SSB抗体有助于提高pSS的诊断,且能提高该病早期诊断,并参与了pSS患者的唾液腺组织损伤及免疫病理改变,但其具体作用机制需要进一步研究明确。
[Abstract]:Objective\%\ This study was the first time in China to detect the expression level of anti SP1 antibody in serum of Han nationality with primary Sjogren's syndrome (PSS) by Western blotting, to explore the significance of anti SP1 antibody in the diagnosis and early diagnosis of the disease, and to analyze its association with disease activity. The relationship between the involvement of various organs and laboratory indexes. Methods: one hundred and nineteen patients with pSS and 50 patients with rheumatoid arthritis (RA) without SS were collected from Department of Rheumatological Immunology and Ophthalmology of the first affiliated Hospital of Xiamen University and 50 healthy subjects were recruited as healthy control group. PSS was divided into two groups: SSA- and SSB-W: SSA-SSB-B group (SSA) or SSB group SSA-SSB-B, group C (SSA-SSB-7), group C (SSA-SSB-7) and group C (SSA-SSB-7). Western blotting was used to detect the expression of anti SP1 antibody in each group, and the relationship between the expression of anti SP1 antibody and disease activity, pathological grade of labial gland biopsy, organ involvement, immunological index and inflammation index in pSS patients was analyzed. Results: the positive rate of anti SP1 antibody in 119 pSS patients of Han nationality was 39.5, which was significantly higher than that in RA group and healthy control group. The specificity was 84g, but significantly higher than that of anti ANA antibody, anti SP1 antibody and SSASSB antibody. The two combined tests or the combined detection of three kinds of antibodies are complementary to each other. The positive rate of single antibody was significantly higher than that of single antibody, among which the positive rate of three kinds of antibody combined detection was the highest. The positive rate of SSA-SSA-SSA-SSA-SSA-SSA-SSA-SSA-SSA-SSA-SSA-SSA or SSB: nd49.555in group C was not significantly different from that in group A and control group (P 0.001. 4). There was no significant difference in ESSDAI between group A and group A (P 0.001. 4) and SP1 negative group (P < 0. 001. 4), but there was no significant difference between group A and control group (P 0. 001. 4). However, the mean course of the patients with anti SP1 antibody positive was 2.5 (卤1.7) years, and the average course of disease was 3.68 (卤2.8) years in the patients with anti SP1 antibody positive than that in the negative patients, and the mean course of the patients with anti SP1 antibody positive was 3. 68 (卤2. 8) years, while that of the patients with anti SP1 antibody positive was 3. 68 (卤2. 8) years. The Chisholm grade of labial gland in the positive group was lower than that in the negative group, especially in group A (鈮，

本文编号：1911667