CAJ | 학술논문

目的探讨原发性胆汁性肝硬化(PBC)、原发性干燥综合征(pSS)和PBC合并干燥综合征(SS)3组患者抗60 000 SSA多倍体寡肽抗原表位(MAPs)抗体阳性率的差异.方法人工合成60 000 SSA的MAPs,酶联免疫吸附试验(ELISA)检测PBC、pSS和PBC合并SS 3组患者的抗MAPs抗体,比较各组抗MAPs抗体阳性率的差异,并分析各抗MAPs抗体与临床症状的关系.采用x2检验、Fisher 精确检验、t检验或Wilcoxon秩和检验进行统计分析.结果抗MAP20抗体阳性率在pSS与PBC合并SS组间差异有统计学意义[分别为25％(7/28),0(0/25); x2=7.201 1,P=0.007 3],PBC合并SS组抗MAP3、MAP7、MAP17抗体检测的阳性率[分别为4％(1/25),4％(1/25),8％(2/25)]类似pSS组[分别为4％(1/28),7％(2/28),7％(2/28％)].在有脾大的患者中抗MAP7抗体及抗MAP12抗体阳性率明显高于无脾大的患者[分别为38％(3/8)和2％(2/84),38％(3/8)和4％(3/84)；P=0.039 4,P=0.039 4],有涎腺损害的患者中抗MAP17抗体阻性率显著低于无涎腺损害的患者[分别为5％(3/64)和39％(5/13); x2=4.431 8,P=0.035 3].结论 PBC、pSS和PBC合并SS 3组患者的抗60 000 SSA抗原表位的抗体谱存在差异,某些抗MAPs抗体阳性率在具有特定临床表现的患者中较高.
목적 탐토원발성담즙성간경화(PBC)、원발성간조종합정(pSS)화PBC합병간조종합정(SS)3조환자항60 000 SSA다배체과태항원표위(MAPs)항체양성솔적차이.방법 인공합성60 000 SSA적MAPs,매련면역흡부시험(ELISA)검측PBC、pSS화PBC합병SS 3조환자적항MAPs항체,비교각조항MAPs항체양성솔적차이,병분석각항MAPs항체여림상증상적관계.채용x2검험、Fisher 정학검험、t검험혹Wilcoxon질화검험진행통계분석.결과 항MAP20항체양성솔재pSS여PBC합병SS조간차이유통계학의의[분별위25％(7/28),0(0/25); x2=7.201 1,P=0.007 3],PBC합병SS조항MAP3、MAP7、MAP17항체검측적양성솔[분별위4％(1/25),4％(1/25),8％(2/25)]유사pSS조[분별위4％(1/28),7％(2/28),7％(2/28％)].재유비대적환자중항MAP7항체급항MAP12항체양성솔명현고우무비대적환자[분별위38％(3/8)화2％(2/84),38％(3/8)화4％(3/84)；P=0.039 4,P=0.039 4],유연선손해적환자중항MAP17항체조성솔현저저우무연선손해적환자[분별위5％(3/64)화39％(5/13); x2=4.431 8,P=0.035 3].결론 PBC、pSS화PBC합병SS 3조환자적항60 000 SSA항원표위적항체보존재차이,모사항MAPs항체양성솔재구유특정림상표현적환자중교고.
Objective To analyze the difference between primary biliary cirrhosis (PBC) and primary Sj(o)gren's syndrome (pSS) and primary biliary cirrhosis complicating with Sj(o)gren's syndrome (SS) in clinical features,anti-60 000 SSA multiple antigenic peptides (MAPs) detection rate,and explore the potential mechanisms of PBC with SS.Methods MAPs were artificially synthesized.Enzyme-linked immunosorbent assay (ELISA) was done to detect anti-MAPs antibodies in the sera of the three groups of patients.The detection rates of anti-MAPs antibodies were compared among groups and the relations of anti-MAPs antibodies with clinical features were analyzed.Chi-square test,Fisher's exact test,t test or Wilcoxon signed rank test were conducted in this study.Results There was no significant difference in clinical features,liver function tests and antibody profiles between PBC and PBC with SS.Significant difference of anti-MAP20 antibody detection rote was detected between pSS and PBC with SS groups [25％(7/28) vs 0(0/25),x2=7.201 1,P=0.007 3],and anti-MAP3,7 and 17 antibody detection rates in PBC with SS patients [4％(1/25),4％(1/25),8％(2/25)] were similar to pSS [4％(1/28),7％(2/28),7％(2/28)].The anti-MAP7 antibody and anti-MAP12 antibody detection rates were significantly higher in patients with splenomegaly than patients without splenomegaly [38％(3/8) vs 2％(2/84),38％(3/8) vs 4％(3/84); P=0.039 4,P=0.039 4],while the antiMAP17 antibody detection rate was significantly lower in patients with salivary gland injury than patients without salivary gland injury [5％(3/64) vs 39％(5/13); x2=4.431 8,P=0.035 3].Conclusion There is significant difference in the anti-MAPs detection rates among the three patients groups,and the detection rate may be higher in patients with certain clinical manifestations.