干燥综合征患者血清抗α-胞衬蛋白、抗SSA/SSB抗体、IFN-γ及TNF-α与唇腺病理损害相关性研究  

Correlation between serum anti-α-lining protein,anti-SSA/SSB antibody,IFN-γ and TNF-α and pathological damage of labial glands in patients with Sjogren’s syndrome

作　　者：赵小莹[1] 白宁[1] 陈群 邱红霞 王喆 刘芯如 惠保卫 ZHAO Xiaoying;BAI Ning;CHEN Qun(Hanzhong Central Hospital in Shaanxi Province,Hanzhong 723000)

机构地区：[1]陕西省汉中市中心医院,汉中723000 [2]西安交通大学医学部公共卫生学院,西安710061 [3]西安市第五医院,西安710082

出　　处：《陕西医学杂志》2020年第2期241-246,共6页Shaanxi Medical Journal

基　　金：国家自然科学基金资助项目(81673115);陕西省自然科学基础研究计划项目(2016JM8147);西安市科技计划项目[2019114613VX0015SF037(4)]

摘　　要：目的:观察干燥综合征患者(SS)血清抗α-胞衬蛋白、干扰素-γ(IFN-γ)、肿瘤坏死因子-α(TNF-α)水平及抗SSA/SSB抗体与患者唇腺活检病理损害的关系,探讨SS患者的抗体表达、免疫异常与唇腺病理损害的相关性。方法:收集SS患者36例为SS组。具有口干症状、慢性非唇腺、唾液腺免疫性炎症的非干燥综合征患者24例为非SS组,两组均行唇腺活检。同时记录患者的一般资料及临床数据,包括年龄、性别、病程、临床体征,记录口干评分,血清学指标包括类风湿因子(RF)、C-反应蛋白(CRP)、血细胞沉降率(ESR),抗SSA/SSB抗体、血清干扰素水平等。结果:①与非SS组比较,SS组唇腺活检阳性率达100%,显著高于非SS组(P<0.05);两组的年龄和性别比较差异无统计学意义(均P>0.05)。②与非SS组比较,SS组的CRP及ESR水平明显增高(P<0.05),抗α-胞衬蛋白、抗SSA/SSB抗体、抗CCP抗体、RF阳性率也高于非SS组。③与轻度病理损伤组比较,中重度病理损伤组抗α-胞衬蛋白的比率无统计学差异;与轻度病理损伤组比较,中重度病理损伤组抗SSB抗体阳性率均明显升高,两组比较差异具有统计学意义,而抗SSA抗体两组间比较无统计学差异(P>0.05)。③TNF-α与每低倍视野下导管扩张数、腺泡萎缩数具有相关性(P<0.05),而CRP、ESR与其未见相关性(P>0.05);TNF-α、CRP和ESR与唇腺灶性指数、淋巴细胞计数均具有相关性(P<0.05);IFN-γ与淋巴细胞计数具有相关性(P<0.05),而与导管扩张数、腺泡萎缩数未见明显相关性(P<0.05)。结论:SS的发病与免疫异常密切相关,SS的唇腺淋巴细胞浸润、腺泡损害等病理损害,可能由于多种自身抗体、细胞因子的作用调控而发生发展的。Objective:To observe the relationship between anti-α-lining protein,interferon-γ(IFN-γ),tumor necrosis factor-α(TNF-α),anti-SSA/SSB antibodies and pathological damage of the labial glands in patients with Sjogren’s syndrome(SS),and explore the correlation between antibody expression,immune abnormality and pathological damage of labial glands in SS patients.Methods:36 confirmed SS patients were collected as the SS group.24 patients with non-Sjogren’s syndrome with xerostomia,chronic non-labial and salivary gland immune inflammation were collected as the non-SS group.Both groups underwent labial biopsy.At the same time,the general information and clinical data of patients were recorded,including age,gender,course of disease,clinical signs,dry mouth scores,serological indicators[rheumatoid factor(RF),C-reactive protein(CRP),blood cell sedimentation rate(ESR),Anti-SSA/SSB antibodies,serum interferon levels,etc].Results:The positive rate of lip gland biopsy in SS group was 100%,which was significantly higher than that in non-SS group(P<0.05).There was no significant difference in age and sex between the two groups(all P>0.05).Compared with non-SS group,CRP and ESR levels in SS group were significantly higher(P<0.05),and the positive rates of anti-a-cell lining protein,anti-SSA/SSB antibody,anti-CCP antibody and RF were also higher.Compared with mild pathological injury group,the ratio of anti-α-cell lining protein in moderate and severe pathological injury group had no significant difference.Compared with mild pathological injury group,the positive rates of anti-SSB antibody in moderate and severe pathological injury group significantly increased,and the difference between the two groups was statistically significant,while there was no statistical difference in anti-SSA antibody between the two groups.TNF-αhad a correlation with the number of catheter dilatations and acinar atrophy per macrovision(P<0.05),but CRP and ESR have no correlation with it(P>0.05).TNF-α,CRP and ESR were correlated with focal index

关 键 词：原发性干燥综合征 Α-胞衬蛋白 抗SSA/SSB抗体 干扰素-Γ 唇腺 病理 

分 类 号：R593.2[医药卫生—内科学]