舟山地区ENA+结缔组织病患者的实验室指标聚类分析  

A cluster analysis based on laboratory indicators of patients combined with connective tissue disease and positive extractable nuclear antigen in Zhoushan area

作　　者：于倩 王晔恺 姚燕珍 YU Qian;WANG Ye-kai;YAO Yan-zhen(Clinical Laboratory,Zhoushan Hospital of Traditional Chinese Medicine,Zhoushan,Zhejiang 316021,China;不详)

机构地区：[1]舟山市中医院检验科,浙江舟山316021 [2]舟山医院检验科,浙江舟山316021

出　　处：《中国卫生检验杂志》2022年第20期2540-2543,2557,共5页Chinese Journal of Health Laboratory Technology

摘　　要：目的对本地区的抗可溶性抗原(extractable nuclear antigen,ENA)阳性的结缔组织病患者的实验室指标进行聚类分析,寻找指标之间内在的依赖关系。方法选取2020年1月—2021年12月本地ENA+的患者173例,其中男性15例,女性158例,年龄为13岁~79岁,平均年龄为(47.99±14.93)岁。免疫印迹法检测抗ENA谱,包括抗增殖性细胞核抗原抗体(PCNA)、抗SSA抗体(SSA)、抗Ro-52抗体(Ro-52)、抗SSB抗体(SSB)、抗Jo-1抗体(Jo-1)、抗着丝点抗体(Ki)、抗线粒体抗体-M2(M2)等共15项,并检测生化指标包括血清谷丙转氨酶(ALT)、谷草转氨酶(AST)、肌酸激酶(CK)、乳酸脱氢酶(LDH)、血清免疫球蛋白G(Ig G)、类风湿因子(RF)、血沉(ESR)等指标。用R程序中的最长距离法进行聚类并分类。结果173例ENA(+)结缔组织病患者在Height 250距离上可将其分为4类:A组(n=5)、B组(n=23)、C组(n=66)、D组(n=79)。A组的年龄、ALT、AST均高于其他组,差异有统计学意义(P<0.01或P<0.05),B组的SSA(>10)、Ro-52(>10)、SSB(>10)比例及Ig G均高于其他组,差异有统计学意义(P<0.01),C组的Jo-1(>10)、Ki(>10)、M2(>10)比例及CK、LDH均高于其他组,差异有统计学意义(P<0.01或P<0.05),D组的PCNA(>10)、RF(>20 IU/ml)比例及ESR高于其他组,差异有统计学意义(P<0.01或P<0.05)。结论ENA+结缔组织病患者的聚类结果为临床的诊疗分类和鉴别诊断提供了有力依据。Objective Cluster analysis was carried out on laboratory indicators of connective tissue disease(CTD)with positive extractable nuclear antigen(ENA)in Zhoushan area,so as to find the intrinsic dependence between indicators.Methods A total of 173 patients with local ENA+from January 2020 to December 2021 were selected,including 15 males and 158 females,with an average age of(47.99±14.93)years(range:13-79 years old).The anti-ENA spectrum was detected by Western blotting,including anti-proliferative nuclear antigen antibody(PCNA),anti-SSA antibody(SSA),anti-Ro-52 antibody(RO-52),anti-SSB antibody(SSB),anti-Jo-1 antibody(Jo-1),anti-kinetochore antibody(Ki),anti-mitochondrial antibody-M2(M2)and so on.Biochemical indexes including serum alanine aminotransferase(ALT),aspartate aminotransferase(AST),creatine kinase(CK),lactate dehydrogenase(LDH),serum immunoglobulin G(Ig G),rheumatoid factor(RF),erythrocyte sedimentation rate(ESR)and other indexes.The longest distance method in R program is used for clustering and classification.Results A total of 173 patients with connective tissue disease and ENA+were divided into 4groups at Height 250,which were respectively group A(n=5),group A(n=23),group A(n=66)and group A(n=79).were divided into 4 groups.Age,ALT and AST of group A were significantlly higher than the others(P<0.01 or P<0.05).SSA(>10),Ro-52(>10),SSB(>10)and Ig G of group B were significantlly higher than the others(P<0.01).Jo-1(>10),Ki(>10),M2(>10),CK and LDH of group C were significantlly higher than the others(P<0.01 or P<0.05).PCNA(>10),RF(>20 IU/ml)and ESR of group D were significantlly higher than the others(P<0.01 or P<0.05).Conclusion Cluster analysis result provide evidence for clinical diagnosis and treatment of ENA+patients with CTD.

关 键 词：可溶性抗原 结缔组织病 聚类分析 

分 类 号：R446[医药卫生—诊断学]