原发性干燥综合征患者临床和血清学性别差异分析及其发病机制研究  

Gender differences in clinical and immunological characteristics and the pathogenic study of primary Sjogren＇s syndrome

作　　者：陈家丽[1] 金月波[1] 李静[1] 陈适[1] 何菁[1] Chen Jiali;Jin Yuebo;Li Jing;Chen Shi;He Jing(Department of Rheumatology and Immunology,Peking University People ＇s Hospital,Beijing 100044,China)

机构地区：[1]北京大学人民医院风湿免疫科,100044

出　　处：《中华风湿病学杂志》2018年第8期526-531,共6页Chinese Journal of Rheumatology

基　　金：国家自然科学基金（31570880,81701607）

摘　　要：目的分析男性及女性pSS患者的临床和免疫学特点，初探其发病机制。方法回顾性分析110例pSS患者的临床及血清学资料；ELISA法测量110例pSS患者（男性20例，女性90例）、30名健康对照血清细胞因子（IL-2，IL-4，IL-6，IL-10，IL-17A，TNF—α，IFN-α的水平，进行t检验和χ2检验。结果与女性pSS患者相比较，男性pSS口眼干燥症状发生率差异无统计学意义（90．0％与98．9％，χ2=4．874，P〉0．05）；男性腮腺及淋巴结肿大发生率更高（40．0％与5．6％，r=18．629，P〈0．01；25．0％与6．7％，χ2=6．111，P均〈0．05）；男性In和补体C4水平更低[分别为2．2（1．5，3．0）g／L与3．3（2．5，5．0）g／L，Z=-3．119，P〈0．05；（0．15±0．05）g/L与（0．19±0．08）g／L，t=-2．659，P〈0．05]；抗SSA／SSB抗体阳性率更低（55，0％与78．8％，χ2=4．921，P〈0．05）。pSS患者IL-2，IL-6，TNF—α水平高于健康对照（t=-3．783，-6．193，-2．065，P均〈0．05）；男性IL-10，IFN叫水平高于女性（t=-1．075，6．286，Pt0〈O．05）；IL-2，TNF—α水平低于女性（t=-3．472，-5．867，P均〈0．01）。结论男女pSS患者体内Th1和Th2细胞分泌的细胞因子水平差异有统计学意义，和两者临床及免疫学特征性别差异可能相关，有助于探讨SS的发病机制。Objective To investigate the clinical and immunological features of primary Sjogren＇s syndrome （pSS） in both sexs, and to find out the pathophysiology of pSS. Methods Clinical data of 110 pSS cases were analyzed retrospectively, and cytokine levels of interleukin （IL）-2, IL-4, IL-6, IL-10, IL-17A, Turnout necrosis factor （TNF）-α, interferon （IFN）-αwere measured （male=20, female=90） in patients and healthy controls （n=30） using enzyme linked immunosorbent assay （ELISA）. Results Compared with female patients, no significant difference was found in male patientsin symptoms of dry mouth and dry eye （90.0% vs 98.9%, AA=4.874, P〉0.05）; the frequency of parotid gland enlargement and lymphadenectasis were higher in male （40.0% vs 5.6%, χ2=18.629, P〈0.01; 25.0% vs 6.7%, χ2=6.111, P〈0.05）; and the level of immunoglobulin （Ig）A and C4 [2.2（1.5, 3.0） g/L vs 3,3（2.5, 5.0） g/L, Z=-3.119, P〈0.01; （0.15±0.05） g/L vs （0.19±0.08） g/L, t=-2.659, P〈0.05] were lower in male, as well as the incidence of positive anti SSA/SSB antibodies （55.0% vs 78.8%,χ2=4.921, P〈0.05）. Cytokine levels of IL-2, IL-6, TNF-α （t=-3.783, -6.193, - 2.065, P〈0.05） were higher in pSS than HC. Compared with female patients, eytokine levels of IL-10, IFN-γ （t=-1.075, 6,286, P〈0.05） were higher in male, however, the levels of IL-2, TNF-α （t=-3.472, -5.867, P〈0.01） were lower in male. Conclusion There are differences in the cytokine levels secreted from Th1 and Th2 cell between male and female patients of pSS, which may relate to the clinical and immunological characteristics and can help to reveal the pathophysiology of pSS.

关 键 词：干燥综合征 原发性 细胞因子 性别差异 

分 类 号：R593.2[医药卫生—内科学]