CAJ | 학술논문

目的：研究抗核糖体P蛋白抗体（ARPA）与神经精神狼疮（NPSLE）的关系。方法收集41例NPSLE患者（NPSLE组）和400例无神经精神表现的SLE患者（nSLE组），采用欧蒙斑点法检测并比较两组患者的血清ARPA，并分析ARPA与其他自身抗体的关系。在90例APRA阳性患者中选择52例联合肾上腺皮质激素和环磷酰胺治疗者（积极治疗组），以及38例仅使用泼尼松未予环磷酰胺治疗者（对照组），随访半年至1年，比较两组 nSLE 患者的 NPSLE 发生率差异。结果 NPSLE组的ARPA阳性率为51.2％，nSLE组的ARPA阳性率为17.3％，两组ARPA阳性率比较差异有统计学意义（P＜0.05）。ARPA与抗双链DNA抗体、抗核糖核蛋白抗体、抗Sm抗体和抗SSA抗体均呈正相关（P＜0.05或0.01）。积极治疗组的NPSLE 发生率明显低于对照组（4％比50％，P＜0.05）。结论 ARPA与NPSLE有关，联合肾上腺皮质激素和环磷酰胺积极治疗能有效降低ARPA阳性者的NPSLE发生率。
목적：연구항핵당체P단백항체（ARPA）여신경정신랑창（NPSLE）적관계。방법수집41례NPSLE환자（NPSLE조）화400례무신경정신표현적SLE환자（nSLE조），채용구몽반점법검측병비교량조환자적혈청ARPA，병분석ARPA여기타자신항체적관계。재90례APRA양성환자중선택52례연합신상선피질격소화배린선알치료자（적겁치료조），이급38례부사용발니송미여배린선알치료자（대조조），수방반년지1년，비교량조 nSLE 환자적 NPSLE 발생솔차이。결과 NPSLE조적ARPA양성솔위51.2％，nSLE조적ARPA양성솔위17.3％，량조ARPA양성솔비교차이유통계학의의（P＜0.05）。ARPA여항쌍련DNA항체、항핵당핵단백항체、항Sm항체화항SSA항체균정정상관（P＜0.05혹0.01）。적겁치료조적NPSLE 발생솔명현저우대조조（4％비50％，P＜0.05）。결론 ARPA여NPSLE유관，연합신상선피질격소화배린선알적겁치료능유효강저ARPA양성자적NPSLE발생솔。
Objective Toinvestigatetherelationshipbetweenanti-ribosomalPproteinantibodies (ARPA)andneuropsychiatricsystemiclupuserythematosus(NPSLE).Methods SerumARPAwasdetected by ICONS blot and compared in 41 NPSLE patients and 400 non-neuropsychiatric lupus (nSLE)couterparts.The association between ARPA and other autoantibodies was analyzed. A total of 90 anti-P-positive systemic lu-pus erythematosus patients were divided into two groups:52 subjects in the active treatment group received glu-cocorticoid combined with cyclophosphamide and 38 in the control group were treated with glucocorticoid alone.The follow-up endured for half a year to 1 year. The incidence of NPSLE in nSLE patients was statistically com-paredbetweentwogroups.Results ThepositiverateofARPAinNPSLEpatientswas51.2%,significantly higher than 1 7.3%in nSLE counterparts (P<0.05 ). The positive rate of ARPA was positively correlated with those of anti-dsDNA,anti-nRNP,anti-Sm and anti-SSA antibodies (P<0.05 or 0.01 ). The incidence of NPSLE in the active treatment group was 4%,significantly lower than 50% in the control group (P<0.05).Conclusions ThepresenceofARPAisassociatedwithNPSLE.Combinedtherapyofglucocorticoidandcyclo-phosphamide is efficacious in reducing the incidence of NPSLE in patients with.positive ARPA.