不同抗体亚型抗合成酶综合征并发间质性肺疾病临床特征分析  

Analysis of the clinical characteristics of different antibody sub-types of anti-syntheses syndrome complicated with lung interstitial lung disease

作　　者：周云 吕成银 尤含笑 徐凌霄 谈文峰 朱玉静 Zhou Yun;Lyu Chengyin;You Hanxiao;Xu Lingxiao;Tan Wenfeng;Zhu Yujing(Department of Rheumatology and Immunology,the First Afiliated Hospital of Nanjing Medical University,Nanjing,210029,China)

机构地区：[1]南京医科大学第一附属医院(江苏省人民医院)风湿免疫科,南京210029 [2]江苏省沭阳医院风湿科工作,沭阳223600

出　　处：《中华风湿病学杂志》2024年第8期538-544,共7页Chinese Journal of Rheumatology

基　　金：国家自然科学基金(81971532,82171794,81971533,82271844)。

摘　　要：目的总结不同抗体亚型抗合成酶综合征(ASS)并发间质性肺疾病(ILD)患者的临床特征差异。方法回顾性分析2019年12月至2023年6月就诊于南京医科大学第一附属医院(江苏省人民医院)的132例ASS-ILD患者的基本信息、临床特征、实验室检查、胸部CT及肺功能等资料,并根据抗氨酰tRNA合成酶(ARS)抗体分为不同亚型。对于正态分布且方差齐的采用两独立样本t检验比较,非正态分布计量资料采用Mann-Whitney U检验比较,对二分类变量资料使用χ^(2)检验或Fisher确切概率法进行比较。结果132例ASS-ILD患者中抗合成酶抗体亚型以抗组氨酸抗体(Jo-1)最常见(60/132,45.5%),其次为抗甘氨酸基tRNA合成酶抗体(EJ)(33/132,25.0%)、抗苏氨酸基tRNA合成酶抗体(PL-7)(26/132,19.7%)、抗丙氨酸基tRNA合成酶抗体(PL-12)阳性(10/132,7.6%)、抗异亮氨酸基tRNA合成酶(OJ)抗体阳性(3/132,2.2%)。抗合成酶抗体合并抗Ro-52双阳性的ASS患者合并快速进展型ILD的比例显著增加。不同亚型ASS-ILD患者中抗Jo-1抗体阳性组合并感染28例(46.7%),合并关节炎/痛27例(45.0%),较其他组更常见(P<0.05);抗EJ抗体阳性组有显著肺功能下降,且咳嗽31例(93.9%)较其他组更常见(χ^(2)=0.15,P=0.047);抗PL-12抗体阳性组肺功能下降较其他组明显(P<0.05),且发热(7例,70.0%)较其他组更常见(χ^(2)=0.02,P=0.022)。结论不同抗合成酶抗体亚型中抗Jo-1、抗PL-7、抗PL-12等抗体亚型在ILD更常见,抗PL-12和抗EJ抗体阳性患者肺功能下降明显。ObjectiveTo summarize the clinical characteristics in of different antibody subtypes in of patients with antisynthetase syndrome(ASS)complicated with interstitial lung disease(ILD).MethodsA retrospective analysis was conducted on 132 ASS-ILD patients at the First Affiliated Hospital of Nanjing Medical University(Jiangsu Provincial People′s Hospital),encompassing a period from December 2019 to June 2023.The data included were basic demographic information,clinical features,laboratory test results,chest computed tomography(CT)scans,and pulmonary lung function tests.Patients were categorized into distinct subtypes based on anti-aminoacyl tRNA synthetase(ARS)antibodies.Statistical analysis was performed using a t-test for comparing means between two samples with equal variance,the Mann-Whitney U test for non-normally distributed continuous data,and the chi-square(χ^(2))test or Fisher′s exact test for categorical variables.ResultsThe most prevalent subtype of anti-synthetase antibody was anti-histidine antibody(Jo-1),accounting for 60 of 132 cases(45.5%),followed by anti-glycine-based tRNA synthetase antibody(EJ)(33/132,25.0%),anti-tRNA synthase antibody(PL-7)(26/132,19.7%),anti-alanine-based tRNA synthetase antibody(PL-12)(7.6%,10/132),anti-isoleucine-tRNA synthase antibody(OJ)(3/132,2.2%).The presence of anti-Ro-52 antibodies was significantly associated with rapidly progressive ILD.In patients with different subtypes of ASS-ILD,the presence of anti-Jo-1 antibodies is was positive in 28 cases(46.7%),and the combination of infection is was more common than in other groups(χ^(2)=0.15,P=0.047).The group with positive anti-EJ antibodies has had a significant decline in lung function,and cough is was more common in 31 cases(93.9%)than in other groups(P<0.05);the group with positive anti-PL-12 antibodies has had a more pronounced decline in lung function than other groups(P<0.05),and fever(7 cases,70.0%)wais more common than in other groups(χ^(2)=0.02,P=0.022).ConclusionAnti-Jo-1,Anti-PL-7,and Anti-PL-12 antibodies

关 键 词：抗合成酶综合征 肺疾病 间质性 临床特征 抗合成酶抗体 

分 类 号：R563[医药卫生—呼吸系统]