血清学指标EULAR干燥综合征疾病活动指数在原发性干燥综合征中的意义  

The significance of serological markers and European League Against Rheumatism SS Disease Activity Index score in patients with primary Sjogren＇s syndrome

作　　者：冯润[1] 龚邦东[1] 程昉[1] 房星星[1] 杨邵英[1] 汤建平[1] 

机构地区：[1]同济大学附属同济医院风湿免疫科,上海200065

出　　处：《中华风湿病学杂志》2016年第7期446-452,共7页Chinese Journal of Rheumatology

基　　金：国家自然科学基金（81273295）

摘　　要：目的探讨血清学指标、EULAR干燥综合征疾病活动指数（ESSDAI）评分和pSS患者病情活动和临床的关系。方法回顾性分析2008年12月至2015年1月在我院住院符合2002年诊断标准的106例pSS患者的临床特点、实验室资料，并进行ESSDAI评分及血清学指标分组[根据低C3／C4、高IgG、RF阳性这几个血清学变量，患者进行血清学预后分组：预后良好组（无血清学标志）；预后中等组（1个血清学标志）；预后不良组（2个或2个以上血清学标志）]，评价PSS患者临床特点、实验室资料、血清学指标分组、ESSDAI评分之间的关系。采用r检验和方差分析进行统计分析。结果106例SS患者平均ESSDAI积分为（11±7）分；按ESSDAI分3个等级，轻（0-4分）；中（5-13分）；重（≥14分），不同的ESSDAI分级ANA1：100阳性比例（6例，37．5％；37例，66．1％；32例，94．1％）差异有统计学意义（x^2=18．110，P〈0．01）；ANA1：100（阳性13±7和阴性7±4）、抗SSA抗体（阳性12±7和阴性9±7）、抗RNP抗体（阳性16±9和阴性10±6）阳性组相对比较组，ESSDAI均值差异有统计学意义（F=8．812，P=0．0001；F=3．862，P=0．024；F=5．786，P=0．004）；抗SSB抗体阳性、RF阳性、唇腺活检阳性、心身科疾病、口干、雷诺现象组相对比较组，ESSDAI均值差异无统计学意义。预后良好组、预后中等组、预后不良组患者的ESSDAI均值差异有统计学意义（分别为8±5、10±7、14±7，F=8．715，P=0．000）；和另外2组比较，预后不良组，ANA1：100（分别为15例，55．6％；20例，57．1％；40例，90．9％）、抗SSA抗体（分别为11例，40．7％；23例，41．1％；36例，81．8％）、抗SSB抗体（分别为6例，22．2％；13例，37．1％；23例，52．3％）、抗RNP抗体阳性率（分别为0例，0；2例，5．7％；9例，20．5％）差异有统计学意义（x^2=17．408，P=0．002；x^2=14．306，P=0�Objective To explore the relationship between the clinical features, serological markers and European League Against Rheumatism SS Disease Activity Index （ESSDAI） scores of primary Sjogren＇s syndrome （SS）. Methods We enrolled 106 patients, who fulfilled the 2002 classification criteria for primary SS from December 2008 to January 2015, to evaluate the relationship among the clinical characteristics, laboratory features, serological variables and ESSDAI scores. According to serological variables, the prognosis was subdivided into three distinct groups： favourable （no serological markers）, intermediate （one serological marker） and poor （two or more serological markers）. These data were analyzed by Chi-square test and variance analysis. Results The mean ESSDAI score of 106 pSS patients was （11 ±7）. ESSDAI score was categorized according to the EULAR-SS recommendations as low activity, moderate activity and high activity （scores of 0-4, 5-13 and ≥ 14, respectively）, and the positive rate of antinuclear antibody （ANA） 1：100 （6 cases, 37.5%; 37 cases, 66.1%; 32 cases, 94.1%） in three different ESSDAI levels was statistically different （x^2=18.110, P〈 0.01）. Those with positive ANA 1：100[positive （13±7） and negative （7±4）], anti-SSA antibody postive （12±7） and negative （9±7）, anti-RNP antibody （positive 16±9 and negative 10±6） had higher ESSDAI scores than those with negative ones （F=8.812, P=0.0001; F=3.862, P=0.024; F=5.786, P=0.004）. No statistieal differenee in ESSDAI means were found between patients with positive anti-SSB antibody, rheumatoid faetor （RF）, FS level, dry mouth, Raynoud＇s phenomenon and psyehosomatic diseases. The ESSDAI scores of favourable group, intermediate group and poor group were significantly different （8±5, 10±7, 14±7, F=8.715, P=0.000 1）. In comparison with the other two groups, the poor pSS patients had a higher frequency of positive ANA 1：100 （15 eases, 55.6%; 20 eases, 57.1%; 40 eases, 90.

关 键 词：干燥综合征 ESSDAI 抗SSA抗体 抗SSB抗体 

分 类 号：R593.2[医药卫生—内科学]