特发性炎性肌病患者酶谱指标、炎症指标、自身抗体水平分析  

Analysis of enzyme spectral indexes,inflammatory indexes and autoantibody levels in patients with idiopathic inflammatory myopathy

作　　者：张铭明[1] 张锐[1] 杨小珂 帅宗文[1] ZHANG Mingming;ZHANG Rui;YANG Xiaoke;SHUAI Zongwen(Department of Rheumatology,First Affiliated Hospital of Anhui Medical University,Hefei,Anhui 230022,China)

机构地区：[1]安徽医科大学第一附属医院风湿免疫科,安徽合肥230022

出　　处：《检验医学与临床》2020年第6期731-735,共5页Laboratory Medicine and Clinic

基　　金：安徽省重点研究与开发项目(1804h08020228)。

摘　　要：目的探讨特发性炎性肌病(IIM)患者的酶谱指标、炎症指标、自身抗体水平。方法利用间接免疫荧光法(IIF)和线性免疫分析法(LIA)比较、分析94例IIM患者[包含20例多发性肌炎(PM)患者和74例皮肌炎(DM)患者]和84例健康体检者的自身抗体[抗核抗体(ANA)、抗SA52抗体、抗SA60抗体、抗Jo-1抗体]及一般实验室指标[酶谱指标丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)、碱性磷酸酶(ALP)、谷氨酰转肽酶(GGT)、乳酸脱氢酶(LDH)、肌酸激酶(CK)、肌酸激酶同工酶(CK-MB)及炎症指标超敏C反应蛋白(hs-CRP)]水平,探讨以上指标在IIM中的意义,同时分析IIM伴间质性肺炎对实验室指标及临床表现的影响。结果IIM患者大部分酶谱指标、炎症指标水平,以及自身抗体阳性率明显高于健康对照者,差异均有统计学意义(P<0.05);抗Jo-1抗体阳性组和阴性组的ANA、抗SA52抗体阳性率比较,差异有统计学意义(P<0.05)。PM组与DM组的AST、LDH、CK、CK-MB水平以及抗SA52抗体、抗Jo-1抗体阳性率差异有统计学意义(P<0.05)。IIM伴间质性肺炎患者乏力、发热、吞咽困难、活动后气短的发生率高于IIM不伴间质性肺炎患者,且抗Jo-1抗体阳性率明显高于IIM不伴间质性肺炎患者。结论IIM具有酶谱指标及炎症指标水平明显升高的特点,酶谱指标AST、LDH、CK、CK-MB及抗SA52抗体、抗Jo-1抗体对PM诊断的意义较大。抗Jo-1抗体作为特异性自身抗体对IIM,尤其是伴间质性肺炎的IIM具有重要的诊断价值。Objective To investigate the levels of enzyme spectral indexes,inflammatory indexes and autoantibody levels in the patients with idiopathic inflammatory myopathy(IIM).Methods The levels of autoantibodies(ANA,anti-SA52 antibody,anti-SA60 antibody and anti-Jo-1 antibody),general laboratory indexes(enzyme spectral indexes ALT,AST,ALP,GGT,LDH,CK,CK-MB)and inflammatory index hs-CRP were comparatively analyzed by using the indirect immunofluorescence(IIF)and linear immunoassay(LIA)in 94 patients with IIM,including 20 cases of polymyositis(PM),74 cases of dermatomyositis(DM)and 84 persons undergoing the health physical examination.The significance of above indexes in IIM was investigated.Meanwhile the influence of IIM complicating interstitial pneumonia on the laboratory indexes and clinical manifestations was analyzed.Results The levels of most enzyme spectrum indexes and inflammation indexes as well as autoantibody positive rate in the IIM patients were significantly higher than those in the healthy controls,the differences were statistically significant(P<0.05);the positive rates of ANA and anti-SA52 antibody had statistical differences between the anti-Jo-1 antibody positive group and anti-Jo-1 antibody negative group(P<0.05);the levels of AST,LDH,CK,CK-MB and the positive rates of anti-SA52 antibody and anti-Jo-1 antibody had statistical differences between the PM group and DM group(P<0.05);the incidence rates of weak,fever,difficulty in swallowing and shortness of breath after exercise in IIM patients with complicating interstitial pneumonia were higher than those in IIM patients without complicating interstitial pneumonia,moreover the positive rate of anti-Jo-1 antibody was significantly higher than that in IIM patients without complicating interstitial pneumonia.Conclusion IIM has the characteristics of significant increase of enzyme spectrum indexes and inflammation indexes,the enzyme spectrum indexes of AST,LDH,CK,CK-MB and anti-SA52 antibody,anti-Jo-1 antibody are of great significance for PM diagnosis,anti-J

关 键 词：间接免疫荧光法 抗核抗体 抗JO-1抗体 

分 类 号：R593.26[医药卫生—内科学]