抗SSA抗体在自身免疫性疾病中的临床应用价值探讨  

Study on the clinical application value of anti-SSA in autoimmune diseases

作　　者：罗丹 伍玉 周春红 曹霞 LUO Dan;WU Yu;ZHOU Chunhong;CAO Xia(Department of Clinical Laboratory,Puer People's Hospital,Yunnan Province,Puer,Yunnan,665000,China)

机构地区：[1]云南省普洱市人民医院检验科,云南普洱665000

出　　处：《当代医学》2022年第23期65-68,共4页Contemporary Medicine

摘　　要：目的分析抗SSA抗体(包括抗Ro60抗体和抗Ro52抗体)阳性患者的可提取核抗原(ENA)抗体谱、抗核抗体(ANA)免疫荧光检测和临床信息,为临床诊断自身免疫性疾病提供参考。方法选取云南省普洱市人民医院2018年1月至2019年1月门诊及住院诊治的471例抗SSA抗体阳性患者作为研究对象,患者均检测ENA抗体谱和ANA,采用免疫印迹法检测ENA抗体谱,间接免疫荧光法检测ANA,分析检测结果。结果在471例抗SSA抗体阳性的患者中,出现3种情况:Ro60(+)Ro52(+)、Ro60(+)Ro52(−)和Ro60(−)Ro52(+)。检测ANA的荧光模型以细胞核斑点型为主,占比35.9%,其次为混合荧光模型,占比34.0%,ANA滴度主要分布于1∶100~1∶3200。抗SSA抗体阳性在ENA抗体谱中与其他6种抗体同时检出的阳性率为:抗nRNP 42.3%、抗SSB 25.8%、抗Rib-P 18.7%、抗Sm 7.7%、抗Jo-13.3%、抗Scl-702.2%。Ro60在自身免疫性疾病中占比高于Ro52,差异有统计学意义(P<0.05);Ro52在非自身免疫性疾病中占比高于Ro60,差异有统计学意义(P<0.05)。结论抗SSA抗体在自身免疫性疾病和非自身免疫性疾病中均有分布,诊断特异性较差,抗SSA抗体阳性应联合检测ENA抗体谱和ANA免疫荧光,并综合患者的临床表现,以降低自身免疫性疾病的误诊率和漏诊率。Objective By analyzing the spectrum of extractable nuclear antigen(ENA)antinuclear antibody(ANA)immunofluorescence detection and clinical information of patients with positive anti-SSA(including anti-Ro60 and anti-Ro52),it provides references for clinical diagnosis of autoimmune diseases.Methods 471 patients with positive anti-SSA antibody in outpatient and inpatient departments of Puer People's Hospital of Yunnan Province from January 2018 to January 2019 were selected as research subjects,the ENA antibody spectrum and ANA were detected,and ENA antibody spectrum was detected by western blotting.Detection of ANA by indirect immunofluorescence and analysis of results.Results In 471 patients with positive anti-SSA,the results were shown in three cases:Ro60(+)Ro52(+),Ro60(+)Ro52(−)and Ro60(−)Ro52(+).The fluorescence model of ANA results detected was mainly 35.9%nuclear speckle type,followed by the mixed fluorescence model of 34.0%,and the ANA titer was mainly distributed from 1∶100 to 1∶3200.The positive rates of anti-SSA positive detected at the same time with the other 6 antibodies in ENA antibody spectrum were:the anti-nRNP 42.3%,anti-SSB 25.8%,anti-Rib-P 18.7%,anti-Sm 7.7%,anti-Jo-13.3%and anti-Scl-702.2%.The proportion of Ro60 in autoimmune diseases was higher than that of Ro52,and the difference was statistically significant(P<0.05);the proportion of Ro52 in non-autoimmune diseases was higher than that of Ro60,and the difference was statistically significant(P<0.05).Conclusion Anti-SSA is distributed in autoimmune diseases and non-autoimmune diseases with poor diagnostic specificity,Anti-SSA positivity should be combined with the detection of ENA antibody profile and ANA immunofluorescence,as well as the patients'clinical presentation,to reduce the rate of misdiagnosis and missed diagnosis of autoimmune diseases.

关 键 词：抗SSA抗体 可提取核抗原 抗核抗体 自身免疫性疾病 

分 类 号：R593.2[医药卫生—内科学]