SS相关抗体在特发性炎症性肌病及其相关间质性肺炎中的临床意义  

Clinical significance of SS related antibodies in idiopathic inflammatory myopathy and its associated interstitial disease

作　　者：尹韦玉 廖红丽[1] 刘媛 YIN Weiyu;LIAO Hongli;LIU Yuan(Department of Rheumatology and Immunology,Liuzhou People's Hospital Affiliated to Guangxi Medical University,Liuzhou 545006,China)

机构地区：[1]广西医科大学附属柳州市人民医院风湿免疫科,545006

出　　处：《天津医药》2024年第7期695-700,共6页Tianjin Medical Journal

基　　金：国家自然科学基金资助项目(82060303);广西壮族自治区卫生健康委员会自筹经费科研课题(Z20210438);广西自然科学基金项目(2021GXNSFAA196009)

摘　　要：目的探讨抗干燥综合征A(SSA)抗体和抗干燥综合征B(SSB)抗体在特发性炎症性肌病(IIM)及IIM相关间质性肺炎(ILD)中的临床意义。方法收集102例IIM患者的一般资料、临床表现、辅助检查,分析IIM患者抗SSA、SSB抗体的阳性率;依据IIM患者抗SSA、SSB抗体检测结果分为SS抗体阴性组(73例)和SS抗体阳性组(29例),分析抗SSA、SSB抗体在IIM及IIM相关ILD中的临床意义。结果与SS抗体阴性组相比,SS抗体阳性组患者更易出现口干、红细胞沉降率(ESR)升高、免疫球蛋白A(IgA)升高(P<0.05)。SS抗体阳性组肌炎活动性评价工具(MDAAT)一般情况评分高于阴性组(P<0.05),余MDAAT项目评分差异无统计学意义(P>0.05)。2组肌炎自身抗体阳性率、复发率、激素治疗、免疫抑制剂治疗比例差异无统计学意义(P>0.05)。SS抗体阳性组应用静脉注射人免疫球蛋白治疗比例高于阴性组(P<0.05)。SS抗体阴性组与阳性组常见ILD类型均为非特异性间质性肺炎(NSIP),其次为普通型间质性肺炎(UIP)。抗SSA、SSB抗体阳性的IIM患者更易进展为合并SS的重叠综合征。结论IIM患者抗SSA、SSB抗体阳性与口干症状相关,抗SSA、SSB抗体可能成为判断患者病情和预测疾病转归的实验室指标。Objective To investigate the clinical significance of anti-Sjögren's syndrome type A antibody(SSA)and anti-Sjögren's syndrome type B antibody(SSB)in idiopathic inflammatory myopathies(IIM)and IIM associated interstitial disease(ILD).Methods A total of 102 patients with IIM were selected.The general information,clinical manifestations and auxiliary examinations were collected.Their positive rates of anti-SSA and anti-SSB antibodies in IIM patients were analyzed.IIM patients were divided into the SS antibody negative group(73 patients)and the SS antibody positive group(29 patients)according to the results of anti SSA and SSB antibody tests.The clinical significance of anti-SSA and anti-SSB antibodies in IIM and IIM related ILD was analyzed.Results Compared with patients in the SS antibody positive group,patients in the SS antibody negative group were more likely to experience dry mouth,increased erythrocyte sedimentation rate(ESR)and increased immunoglobulin A(IgA)levels(P<0.05).The general situation score of the MDAAT(myositis disease activity assessment tool)was significantly higher in the SS antibody positive group than that in the SS antibody negative group(P<0.05),and there were no significant differences in scores of other MDAAT items between the two groups(P>0.05).There were no significant differences in the positive rate of myositis autoantibodies,recurrence rate,hormone therapy and immunosuppressive therapy between the two groups(P>0.05).The proportion of patients treated with intravenous human immunoglobulin was higher in the SS antibody positive group than that of the SS antibody negative group(P<0.05).Non-specific interstitial pneumonia(NSIP)was the most type of ILD in both the SS antibody negative group and the positive group,followed by usual interstitial pneumonia(UIP).Patients with IIM who were positive for anti-SSA/SSB antibodies were more likely to progress to the overlapping syndrome of combined SS.Conclusion Positive anti-SSA and anti-SSB antibodies in IIM patients are associated with dry mout

关 键 词：特发性炎性肌病 干燥综合征 肺疾病 间质性 自身抗体 抗SSA抗体 抗SSB抗体 

分 类 号：R593.26[医药卫生—内科学]