CAJ | 학술논문

目的探讨抗SSA60抗体和抗SSB抗体在SLE患者中的检出率及其在SLE中的意义.方法选取2007-2010年在我院确诊为SLE的患者251例,免疫印迹法和免疫双扩散法检测抗SSA60抗体及抗SSB抗体,同时观察患者的临床症状和重要脏器或系统受累情况;对上述患者定期随访3年,观察其出现口干、眼干及进展为SS的情况.统计学方法采用x2检验和t检验.结果 ①抗SSA60抗体在SLE患者中的检出率为65.3％,抗SSB抗体在SLE患者中的检出率为28.3％;②随访3年,抗SSA60抗体(48例,29.3％)或抗SSB抗体阳性(25例,35.2％)的SLE患者更易出现眼干燥症(P＜0.05),并且在SLE基础上易合并干燥综合征(P＜0.05);③抗SSA60抗体阳性的患者比阴性的患者更易出现浆膜炎(20.7％和8.0％)、神经精神性狼疮(18.9％和8.0％)、血尿(35.4％和21.8％)(P＜0.05),而抗SSB抗体阳性的患者相对于阴性的患者来说,其出现发热的概率要小(43.7％和57.8％)(x2=4.082,P＜0.05);④抗SSB抗体阳性的患者同时出现抗Sm抗体的阳性的比率要比阴性患者高(50.7％和32.8％)(x2=6.956,P＜0.05);⑤年龄越小的SLE患者越容易出现抗SSA60抗体和(或)抗SSB抗体的阳性(P＜0.05);⑥抗SSA60抗体阳性的患者,SLEDAI积分比阴性患者的高[(17±9)和(15±7),t=2.389,P＜0.05],而抗SSB抗体阳性的患者IgG水平高于抗SSB抗体阴性的患者[(18±7)和(16±6) mg/L,t=2.304,P=0.023],CRP水平低于抗SSB抗体阴性的患者[(14±20)和(21±33) mg/L,t=-2.173,P=0.031].结论抗SSA60抗体阳性的SLE患者SLEDAI积分更高,病情更重;抗SSA60抗体或抗SSB抗体阳性的SLE患者易出现眼干燥症,且易在SLE的基础上合并SS.
목적 탐토항SSA60항체화항SSB항체재SLE환자중적검출솔급기재SLE중적의의.방법 선취2007-2010년재아원학진위SLE적환자251례,면역인적법화면역쌍확산법검측항SSA60항체급항SSB항체,동시관찰환자적림상증상화중요장기혹계통수루정황;대상술환자정기수방3년,관찰기출현구간、안간급진전위SS적정황.통계학방법채용x2검험화t검험.결과 ①항SSA60항체재SLE환자중적검출솔위65.3％,항SSB항체재SLE환자중적검출솔위28.3％;②수방3년,항SSA60항체(48례,29.3％)혹항SSB항체양성(25례,35.2％)적SLE환자경역출현안간조증(P＜0.05),병차재SLE기출상역합병간조종합정(P＜0.05);③항SSA60항체양성적환자비음성적환자경역출현장막염(20.7％화8.0％)、신경정신성랑창(18.9％화8.0％)、혈뇨(35.4％화21.8％)(P＜0.05),이항SSB항체양성적환자상대우음성적환자래설,기출현발열적개솔요소(43.7％화57.8％)(x2=4.082,P＜0.05);④항SSB항체양성적환자동시출현항Sm항체적양성적비솔요비음성환자고(50.7％화32.8％)(x2=6.956,P＜0.05);⑤년령월소적SLE환자월용역출현항SSA60항체화(혹)항SSB항체적양성(P＜0.05);⑥항SSA60항체양성적환자,SLEDAI적분비음성환자적고[(17±9)화(15±7),t=2.389,P＜0.05],이항SSB항체양성적환자IgG수평고우항SSB항체음성적환자[(18±7)화(16±6) mg/L,t=2.304,P=0.023],CRP수평저우항SSB항체음성적환자[(14±20)화(21±33) mg/L,t=-2.173,P=0.031].결론 항SSA60항체양성적SLE환자SLEDAI적분경고,병정경중;항SSA60항체혹항SSB항체양성적SLE환자역출현안간조증,차역재SLE적기출상합병SS.
Objective To investigate the detection rate of anti-SSA60 and SSB antibodies in sera of patients with systemic lupus erythematosus (SLE).The correlation of anti-SSA and SSB antibodies with SLE clinical outcome was also investigated.Methods This study included 251 cases of SLE diagnosed in our hospital between 2007 and 2010.ELISA and double immunodiffusion method was used to detect the sera antiSSA60 and SSB antibodies.The patients were closely monitored for three years in terms of clinical and laboratory parameters and the presence of associated Sj(o)gren' s syndrome (SS).Statistical analysis were performed using student t test or x2 test.Results ① The detection rate of anti-SSA60 antibody in serum of patients with SLE was 65.3％.The detection rate of anti-SSB antibody in serum of patients with SLE was 28.3％; ② During the three-year follow up,patients with anti-SSA60 (29.3％,48 cases) or SSB antibodies (35.2％,25 cases) were more likely to have dry mouth and eyes and later developed SS (P＜0.05); ③ Patients with anti-SSA60 antibody were more likely to develop serositis (20.7％ vs 8.0％),neuropsychiatric lupus erythematosus (NPLE)(18.9％ vs 8.0％),and hematuria (35.4％ vs 21.8％)(P＜0.05).Patients with negative anti-SSB antibody were more likely to have fever (43.7％ vs 57.8％,x2=4.082,P＜0.05); ④ Patients positive for anti-SSB antibody were also positive for anti-Sm antibody (50.7％ vs 32.8％,x2=6.956,P＜0.05);⑤ Younger patients were more likely to have anti-SSA60 and SSB antibodies in their sera (P＜0.05); ⑥Patients positive for anti-SSA60 antibody had higher SLE disease activity index (SLEDAI) than patients with negative anti-SSA60 antibody [(17±9) vs (15±7),t=2.389,P＜0.05].Patients positive for anti-SSB antibody had higher level of IgG [(18±7) vs (16±6) g/L,t=2.304,P=0.023],and lower level of CRP than patients negative for anti-SSB antibody [(14±20) vs (21±33) mg/L,t=-2.173,P=0.031].Conclusion Patients positive for anti-SSA60 antibody have higher SLEDAI and more severe clinical outcomes.Patients with antiSSA or anti-SSB antibody are more likely to develop dry mouth and eyes which eventually leads to SS.