抗α-胞衬蛋白抗体用于干燥综合征诊断的临床价值  

Clinical Value of Anti-α-fodrin Antibodies in Sjgren's Syndrome

作　　者：马倩[1] 项楠[2] 李向培[2] 厉小梅[2] 汪国生[2] 马艳[2] 张宏[2] 王玮[2] 陈磊[2] 

机构地区：[1]浙江大学医学院附属儿童医院,杭州310003 [2]安徽医科大学附属安徽省立医院风湿免疫科,合肥230001

出　　处：《中华临床免疫和变态反应杂志》2015年第3期182-186,共5页Chinese Journal of Allergy & Clinical Immunology

基　　金：卫生行业科研专项项目(2012020)

摘　　要：目的研究抗α-胞衬蛋白抗体在诊断干燥综合征(Sjgren syndrome,SS)中的敏感性和特异性,探讨其对诊断SS的临床应用价值。方法采用酶联免疫吸附法检测SS组、结缔组织病(connective tissue diseases,CTD)、非CTD对照组血清抗α-胞衬蛋白抗体,分析各组间抗α-胞衬蛋白抗体的敏感性、特异性。结果 SS患者253例,其中原发性干燥综合征(primary Sjgren’s syndrome,p SS)患者204例,继发性干燥综合征(secondary Sjgren’s syndrome,s SS)49例;CTD组60例,其中类风湿关节炎(rheumatoid arthritis,RA)22例,系统性红斑狼疮(systemic lupus erythematosus,SLE)38例;非CTD对照组105例。SS、p SS、s SS组抗α-胞衬蛋白抗体的敏感性分别为51.4%、52.0%、49.0%;RA、SLE组为18.2%、26.3%;特异性分别为81.8%、74.8%、63.1%、60.6%和60.5%。SS组抗α-胞衬蛋白抗体的敏感性高于RA、SLE组,差异有统计学意义(P<0.05),p SS组与s SS组敏感性差异无统计学意义(P>0.05);非CTD对照组的敏感性低于其余各组,差异有统计学意义(P<0.05)。p SS组抗α-胞衬蛋白抗体的特异性高于其余各组,差异有统计学意义(P<0.05)。ANA、抗SSA及抗SSB抗体均阴性SS患者的抗α-胞衬蛋白抗体的阳性率为62.5%。SS患者中抗SSA抗体、抗SSB抗体及抗α-胞衬蛋白抗体阳性患者为42.5%。结论抗α-胞衬蛋白抗体在SS诊断中有一定的临床价值,抗α-胞衬蛋白抗体可作为诊断SS联合检测抗体,在其他抗体阴性的疑诊SS患者具有补充诊断价值。Objective To evaluate the sensitivity and specificity of anti-α- fodrin antibodies and explore its clinical value in the diagnosis of Sjogren＇ s syndrome （ Sjogren syndrome, SS）. Methods The serum anti- α-fodrin antibodies in patients with SS, connective tissue diseases （CTD）, and non-CTD were determined by ELISA. The difference of sensitivity and specificity in each groups was analyzed. Results The sample was collected from 253 patients with SS including 204 primary Sjogren＇ s syndrome （pSS） patients and 49 secondary Sjogren＇ s syndrome （sSS） patients, 60 patients with CTD including 22 rheumatoid arthritis （RA） patient and 38 systemic lupus erythematosus （ sensitivity of anti-α- fodrin antibody in SS, pSS, sSS SLE） patients, and 105 patients with non-CTD. The patients was 51.4%, 52.0%, and 49% ; while the sensitivity in RA, SLE patients was 18.2% and 26.3%. The specificity of anti-α- fodrin antibody was 81.8%, 74. 8%, 63.1%, 60. 6%, and 60. 5%. The sensitivity of anti-α- fodrin antibody in SS patients was significantly higher than RA and SLE patients （P 〈 0. 05 ）. It showed no significant difference between pSS and sSS. The sensitivity in non-CTD group was significantly lower than other groups. The specificity of anti-α- fodrin antibody in pSS group was significantly higher than other groups. The anti-u- fodrin antibody was detected in 62.5% in ANA, anti-SSA and anti-SSB negative SS patients. SS patients with anti-SSA, anti-SSB and anti-α- fodrin antibodies were positive for 42.5%. Conclusion Anti-α-fordin antibodies may be diagnostic for SS. Anti-α- fodrin antibodies can detect antibodies as a joint diagnosis of SS. It cna be a complementary diagnostic maker in suspected SS patients with negative antibodies.

关 键 词：Α-胞衬蛋白 抗Α-胞衬蛋白抗体 干燥综合征 

分 类 号：R593.2[医药卫生—内科学]