抗SSA60抗体和抗SSB抗体在系统性红斑狼疮患者血清中的检出率及其意义  

Prevalence and significance of anti-SSA60 antibodies and anti-SSB antibodies in systemic lupus erythematosus patients

作　　者：鲁芙爱[1] 刘媛[1] 王凯丽[1] 王永福[1] 

机构地区：[1]包头医学院第一附属医院风湿免疫科,014010

出　　处：《中华风湿病学杂志》2014年第4期248-254,共7页Chinese Journal of Rheumatology

摘　　要：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.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＆#39; 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 positiv

关 键 词：红斑狼疮 系统性 抗SSA60抗体 抗SSB抗体 

分 类 号：R593.241[医药卫生—内科学]