抗SSA60、SSA52、SSB/La抗体及抗着丝点B抗体在老年性干燥综合征干眼症诊断中的意义  

Significance of anti-SSA60,anti-SSA52,anti-SSB/La,anti-centromere B antibodies in the diagnosis of dry eye due to senile Sjogren's syndrome

作　　者：胡海林 方思捷 崔昌 王俊芳 赵福涛[2] Hu Hailin;Fang Sijie;Cui Chang;Wang Junfang;Zhao Futao(Department of Ophthalmology,the Ninth People’s Hospital,Shanghai Jiaotong University School of Medicine,Shanghai 200011,China;Department of Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology,Shanghai 200011,China;Department of Rheumatology and Immunology,the Ninth People's Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200011,China)

机构地区：[1]上海交通大学医学院附属第九人民医院眼科,上海市眼眶病眼肿瘤重点实验室,200011 [2]上海交通大学医学院附属第九人民医院风湿免疫科

出　　处：《临床眼科杂志》2020年第3期223-227,共5页Journal of Clinical Ophthalmology

基　　金：上海市重点实验室资助(No.17DZ2260100)。

摘　　要：目的探讨抗SSA60、SSA52、SSB/La抗体及抗着丝点B抗体在老年性干燥综合征干眼症诊断中的意义。方法选取2015年7月至2019年11月在我院风湿免疫科和眼科就诊的老年性干燥综合症患者157例,在确诊为干眼的患者中采用免疫印迹法和双扩散法检测抗SSA60、SSA52、SSB/La抗体及抗着丝点B抗体的表达情况。比较泪液分泌时间、泪膜破裂时间、角膜荧光素染色评分和干眼评分四个指标,分析其意义。结果老年性干燥综合症患者中,有79例为干眼症,阳性率为50.3%。其中抗SSA60抗体、抗SSA52抗体、抗SSB/La抗体,抗着丝点B抗体阳性比例分别为52.2%,占52.2%,占33.1%,占11.4%。抗SSA60抗体、抗SSA52抗体、抗SSB/La抗体阳性和阴性患者在老年性干燥综合征患者干眼症中比较都有统计学意义(P<0.01),抗着丝点B抗体阳性和阴性患者在老年性干燥综合征患者的干眼症中比较有统计学意义(P<0.05)。抗SSA60抗体阳性、抗SSA52抗体阳性的患者相对于阴性患者来说,出现泪液分泌时间和泪膜破裂时间短、角膜荧光素染色评分和干眼评分高,两组患者差异均有统计学意义(P<0.001)。抗SSB/La抗体阳性的患者相对于阴性患者来说,出现泪液分泌时间和泪膜破裂时间短、角膜荧光素染色评分和干眼评分高,两组患者差异均有统计学意义(P<0.01)。抗着丝点B抗体阳性的患者相对于阴性患者来说,出现泪液分泌时间短,两组患者差异有统计学意义(P<0.05)。两组患者泪膜破裂时间、角膜荧光素染色评分、干眼评分差异无统计学意义(P>0.05)。结论抗SSA60、SSA52、SSB/La抗体及抗着丝点B在老年性干燥综合征中干眼症患者中被检测比例高,4种抗体的联合检测能提示干眼症的发生,其中抗SSA60抗体、抗SSA52抗体、抗SSB/La抗体可能意义更大。Objective To investigate the significance of anti-SSA60,anti-SSA52,anti-SSB/La,anti-centromere B antibodies in the diagnosis of dry eye due to senile Sjogren's syndrome.Methods A total of 157 elderly patients with Sjogren's syndrome were randomly selected from July 2015 to November 2019 in the rheumatology department and ophthalmology department of our hospital.Immunoblotting and double diffusion were used to detect the expression of anti-SSA60,anti-SSA52,anti-SSB/La,anti-centromere B antibodies in the patients with dry eye.Four indexes including secretion test,shorter tear rupture time,higher corneal fluorescein staining score and dry eye score were compared.Results Among the elderly patients with Sjogren's syndrome,79 had xerophthalmia with a positive rate of 50.3%.The positive rate of anti-SSA60,anti-SSA52,anti-SSB/La,anti centromere-B antibodies was 52.2%,52.2%,33.1%and 11.4%,respectively.The patients positive for anti-SSA60,anti-SSA52,anti-SSB/La antibodies and anti-centromere B antibodies were all significantly different in dry eye due to senile Sjogren's syndrome from those negative patients(P<0.05).Compared with the negative patients,the patients with positive anti-SSA60,anti-SSA52,anti-SSB/La antibodies had shorter tear secretion time,shorter tear rupture time,higher corneal fluorescein staining score and dry eye score,and the difference was statistically significant(anti-SSA60,anti-SSA52 antibodies:P<0.001;anti-SSB/La antibodies:P<0.01).Compared with the negative patients,the patients with positive anti-centromere B antibodies had significantly shorter tear secretion time(P<0.05).There was no significant difference in tear break time,corneal fluorescein staining score or dry eye score between the two groups(P>0.05).Conclusions The anti-SSA60,anti-SSA52,anti-SSB/La,anti-centromere B antibodies were detected in a high proportion of patients with dry eye due to senile Sjogren's syndrome.The combined detection of the four antibodies can indicate the occurrence of dry eye,among which anti-SSA60,antiSSA52 and

关 键 词：抗SSA60抗体 抗SSA52抗体 抗SSB/La抗体 抗着丝点B抗体 老年干燥综合征 干眼症 

分 类 号：R777.34[医药卫生—眼科] R593.2[医药卫生—临床医学]