抗α-胞衬蛋白抗体在干燥综合征诊断中的意义及与临床表现的相关性  

Significance of anti-α-fodrin antibody in the diagnosis of Sjgren′s syndrome and its correlation with clinical manifestations

作　　者：赵岩[1] 费允云[2] 邓学 张佩莲[3] 甘晓丹[1] 史艳萍[1] 周炜[1] 董怡[1] 

机构地区：[1]中国医学科学院中国协和医科大学北京协和医院风湿免疫科,100730 [2]中国医学科学院中国协和医科大学北京协和医院内科,100730 [3]昆明医学院第一附属医院风湿免疫内科

出　　处：《中华风湿病学杂志》2005年第5期261-264,共4页Chinese Journal of Rheumatology

基　　金：国家自然科学基金资助项目(30300164)

摘　　要：目的α-胞衬蛋白(α-fodrin)是干燥综合征(SS)患者涎腺组织中的一种特异性自身抗原,本研究应用重组人类α-fodrin抗原、酶联免疫吸附试验定量测定患者血清中的抗α-fodrin抗体,了解抗α-fodrin抗体在SS诊断中的意义及与临床表现的相关性。方法以重组人类α-fodrin为包被抗原,酶联免疫吸附试验定量检测42例原发性干燥综合征(pSS)、24例继发性干燥综合征(sSS)、40例其他结缔组织病、42名正常人血清中的抗α-fodrin抗体。结果以x±5s为标准,α-fodrin抗体在pSS、sSS患者阳性率分别为59.5%、37.5%,在其他结缔组织病和对照组阳性率分别为35.0%、11.3%;抗α-fodrin抗体在SS患者的特异性为79.4%;pSS患者与sSSα-fodrin抗体阳性率差别无统计学意义(P>0.05);SS患者与其他结缔组织病阳性率差别无统计学意义(P>0.05);在结缔组织病中的阳性率明显高于非结缔组织病和正常人(P<0.01)。抗α-fodrin抗体与pSS或sSS患者临床表现、其他自身抗体无明显相关性,抗α-fodrin抗体阳性患者血IgG水平、血沉(ESR)较抗α-fodrin抗体阴性患者高,P值分别为0.044和0.03。抗SSA抗体和抗核抗体(AN A)均阴性的SS患者抗α-fodrin抗体也均阴性。结论①抗α-fodrin抗体对于pSS或sSS的诊断有一定意义,但是它的特异性和敏感性并不理想。②抗α-Objective To investigate the sensitivity and specificity of anti-α-fodrin antibody in patients with Sjo¨gren′s syndrome (SS) and its correlation with clinical manifestations. Methods Recombinant human α-fodrin was used as envelope antigen in enzyme-linked immunosorbent assay (ELISA) to detect the relatively specific autoantibody in sera of 42 primary SS, 24 secondary SS with SLE or RA, and 40 other CTDs (SLE 17, RA 8, AS 5, PM 5, SSc 3, MCTD 1, TA 1). Results Antibody against α-fodrin was present in 59.5% of primary SS patients, 37.5% of secondary SS patients, 35.0% and 11.3% of other CTD patients and controls respectively; the specificity of anti-α-fodrin antibody was 79.4% in patients with SS. It showed no significant difference between primary and secondary SS (P>0.05), as well as SS compared with other CTD patients(P>0.05). The positive rate of antibody against α-fodrin in CTD patients was significantly higher than those in non-CTD patients and normal controls (P<0.01). The presence of anti-α-fodrin antibody had no significant correlation with clinical manifestations or other autoantibodies, but the levels of sera IgG and ESR were higher in α-fodrin antibody positive patients (IgG: 23.2 vs 18.6, P=0.04; ESR: 52.9 vs 37.1, P=0.03). Anti-α-fodrin antibody was negative in anti-SSA and ANA negative SS patients. Conclusions The results show that the sensitivity and specificity of anti-α-fodrin antibody as a diagnostic marker of SS is lower compared with previous reports. Anti-α-fodrin antibody has no significant association with clinical manifestations, but it may be related to the activity of disease. Antibody against α-fodrin plays no important role in the diagnosis of antibody-negative SS patients.

关 键 词：临床表现 相关性 综合征诊断 蛋白抗体 酶联免疫吸附试验 抗核抗体(ANA) 结缔组织病 原发性干燥综合征 继发性干燥综合征 Α-胞衬蛋白 抗SSA抗体 抗体阳性率 IgG水平 pSS sSS 自身抗原 种特异性 涎腺组织 定量测定 包被抗原 

分 类 号：R593.2[医药卫生—内科学]