血清IgG及亚类在原发干燥综合征中的意义  

Study on the significance of serum IgG and IgG subclasses in primary Sjgren's syndrome

作　　者：齐海宇[1] 宋淑菊[1] 段婷[1] 阴赪宏[2] QI Hai - yu SONG Shu - ju DUAN Ting et al(Department of Rheumatology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China.)

机构地区：[1]首都医科大学附属北京友谊医院风湿科,北京100050 [2]首都医科大学附属北京妇产医院内科,北京100026

出　　处：《临床和实验医学杂志》2017年第9期844-847,共4页Journal of Clinical and Experimental Medicine

基　　金：国家自然科学基金青年基金项目(编号:81601364);北京市医院管理局青年人才培养"青苗"计划项目(编号:QML20150106);首都医科大学基础-临床科研合作基金(编号:15JL26)

摘　　要：目的分析原发干燥综合征(pSS)患者血清IgG水平及其亚类分布特点和临床意义。方法回顾性分析2015年1月至2016年12月在首都医科大学附属北京友谊医院风湿科住院未经治疗的30例pSS患者的临床资料,应用免疫散射比浊法检测血清IgG和IgG亚类含量,根据血清IgG水平分为IgG升高组和IgG正常组。对比观察血清IgG升高组和IgG正常组的SSA抗体阳性比率、红细胞沉降率(ESR)、WBC计数、中性粒细胞(GR)计数、淋巴细胞(LY)计数、门冬氨酸氨基转移酶(AST),血红蛋白(HGB)、IgG4/IgG水平;SSA抗体阳性与SSA抗体阴性患者的IgG1水平。结果本组30例pSS患者中,26例为女性(86.7%),4例为男性(13.3%),年龄34~76岁,平均年龄(57.60±12.47)岁;有系统受累7例(23.3%),无系统受累23例(76.7%);63.3%患者血清IgG升高。与血清IgG正常的pSS患者相比,血清IgG升高组SSA抗体阳性比率、ESR、AST较高,WBC、GR、LY计数,HGB,IgG4/IgG水平较低(P<0.05)。SSA抗体阳性pSS患者血清IgG1水平明显高于SSA抗体阴性患者。结论 pSS患者血清IgG升高常见,与多种自身抗体产生有关,参与疾病致病过程。抗SSA/SSB阳性患者血清IgG升高,抗SSA阳性pSS患者血清IgG1含量更高。Objective To study the clinical significance of serum levels of IgG and IgG subclasses in patients with primary Sjgren＇s syndrome（ pSS）. Methods The clinical data of 30 untreated patients with pSS admitted to this hospital during January,2015 to December,2016 were retrospectively analyzed. Serum levels of IgG and IgG subclasses were detected by immuno-turbidimetry,and they were divided into IgG elevated group and IgG normal group according to serum levels of IgG. The positive rates of SSA,erythrocyte sedimentation rate（ ESR）,white bloodcell count（ WBC）,neutrophile granulocyte count（ GR）,lymphocyte count（ LY）,level of aspartate aminotransferase（ AST） and hemoglobin（ Hgb）,level of IgG 4/IgG,and level of IgG 1 were compared between patients with positive SSA antibody and negative SSA antibody. Results Among 30 patients with pSS,26 of them were females（ 86. 7%）,4 were males（ 13. 3%）,age range at 34 to 76 years with mean age of（ 57. 60＋ 12. 47） years,and 7 cases（ 23. 3%） with systematic involvement,23 cases（ 76. 7%） without systemic involvement; and 63. 3% patients with elevated serum level of IgG. The positive rates of SSA,ESR and AST were significantly higher in patients with elevated serum level of IgG than those of patients with normal serum level of IgG. The amounts of WBC count,neutrophil count（ GR）,lymphocyte count（ LY） and levels of Hgb and IgG 4/IgG were lower（ P 0. 05）. Serum levels of IgG 1 in SSA-positive pSS patients were significantly higher than those of SSA-negative patients. Conclusion The increase of serum level of IgG in patients with pSS is related to the production of autoimmuno-antibodies,and it is involved in the pathogenesis of disease. Serum level of IgG is increased in patients with primary Sjgren＇s syndrome and positive anti-SSA/SSB,and serum level of IgG 1 is higher in patients with positive anti-SSA.

关 键 词：原发干燥综合征 IGG IGG亚类 临床表现 

分 类 号：R593.2[医药卫生—内科学]