抗Ku抗体阳性40例临床特征分析  

Clinical features of 40 cases of anti-Ku antibody associated disease

作　　者：杨绮华 张欣[1] 吕坤龙 张磊[1] 贺玉杰[1] 刘升云[1] Yang Qihua;Zhang Xin;Lyu Kunlong;Zhang Lei;He Yujie;Liu Shengyun(Department of Rheumatology and Immunology,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,China;Department of Urology,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,China)

机构地区：[1]郑州大学第一附属医院风湿免疫科,450000 [2]郑州大学第一附属医院泌尿外科,450000

出　　处：《中华风湿病学杂志》2021年第6期378-382,I0002,共6页Chinese Journal of Rheumatology

摘　　要：目的通过分析抗Ku抗体阳性患者的临床特征,旨在提高对抗Ku抗体相关疾病的临床特征及预后的认知。方法回顾性收集2017年9月至2019年9月郑州大学第一附属医院40例抗Ku抗体阳性患者的临床症状、实验室检查及预后,并进行层次聚类分析,并对聚类分析得到的3组患者间进行对比。结果40例患者平均年龄(48±18)岁,男女比例为1∶4。平均随访(11±7)个月,其中伴发恶性肿瘤2例,死亡3例。最常见的脏器受累为间质性肺疾病,共24例(60%);最常见的疾病诊断为炎性肌病,共11例(28%),其次为SLE 9例(22%)。根据40例抗Ku抗体阳性患者的32项临床特征及实验室检查进行层次聚类分析后,40例患者被分为3组,其中A组的间质性肺疾病(84%,P<0.01)发生率最高,肾脏受累(0)、血细胞减少(0)、浆膜炎(0)的发生率最低(P均<0.01),抗组氨酰tRNA合成酶(Jo-1)抗体阳性率最高(16%,P=0.44),但差异无统计学意义,更为符合炎性肌病的特点;而C组的肾脏受累(57%)、狼疮皮疹(71%)、血细胞减少(57%)、低补体(71%)的发生率以及狼疮相关抗体(如抗dsDNA抗体、抗Sm抗体、抗His抗体)、抗Nuc抗体、Rib抗体阳性率最高(P均<0.05),更符合SLE的疾病特点,这2组患者有各自显著的生物学特征,几乎没有重叠。结论抗Ku抗体可以出现在各种自身免疫病中,其中最常见的为炎性肌病,其次为SLE。抗Ku抗体阳性的患者很少出现SLE和肌炎重叠,整体预后良好,但需警惕肿瘤等并发症。Objective By analyzing the clinical characteristics of anti-Ku antibody associated disease,this paper aims to improve the diagnosis and treatment level of it.Methods The clinical symptoms,laboratory tests and prognosis of 40 anti-Ku-antibody positive patients from the First Affiliated Hospital of Zhengzhou University from September 2017 to September 2019 were retrospectively collected,and then hierarchical clustering analyzed.Results The average age of 40 anti-Ku positive patients was 48±18 years,and the male to female ratio was 1∶4.The average follow-up was(11±7)months,of which 2 cases were accompanied by malignant tumors and 3 cases died.Interstitial lung disease was most common and was found in 24 cases(60%).The most common disease was inflammatory myopathy(11 cases,28%),followed by systemic lupus erythematosus(SLE)(9 cases,22%).According to hierarchical cluster analysis,the anti-Ku-antibodies positive patients were divided into 3 groups.Among them,group A had the highest incidence of pulmonary interstitial fibrosis(84%,P<0.01),and the lowest incidence of renal involvement(0,P<0.01),cytopenia(0,P<0.01),serositis(0,P<0.01).Although the incidence of anti-Jo-1 antibody positivity in group A was the highest(16%,P=0.44)but without statistically significant difference.The characters of group A were in line with inflammatory myopathy.Group C had the highest incidence of renal involvement(57%),lupus rash(71%),cytopenia(57%),low complement(71%)and lupus-related antibodies positivity(P value were all<0.05),which was in line with SLE.These two groups had their own significant biological characteristics,and were rarely overlapped.Conclusion Anti-Ku antibody appears in a wide spectrum of autoimmune diseases,among which inflammatory myopathy is the most common,followed by SLE.Patients with anti-Ku antibody rarely have SLE and myositis overlapped,and the overall prognosis is good,but it is necessary to be alert to complications,such as tumors.

关 键 词：抗Ku抗体 抗DSDNA抗体 间质性肺疾病 炎性肌病 重叠综合征 

分 类 号：R593.2[医药卫生—内科学]