50例儿童系统性红斑狼疮抗核抗体及抗核抗体谱水平聚类分析  

Level and cluster analysis of anti-nuclear antibody and antinuclear antibody spectrum in 50 childhood systemic lupus erythematosus

作　　者：王丹 蒋树娟 杨娟[1] 张秀敏 王敬彩[1] 郭翠翠 WANG Dan;JIANG Shujuan;YANG Juan;ZHANG Xiumin;WANG Jingcai;GUO Cuicui(Department of Pediatrics,Liaocheng People's Hospital,Shandong Province,Liaocheng252000,China)

机构地区：[1]山东省聊城市人民医院儿科,山东聊城252000

出　　处：《中国当代医药》2024年第33期83-87,共5页China Modern Medicine

基　　金：山东省医药卫生科技发展计划项目(202006010083)。

摘　　要：目的分析50例儿童系统性红斑狼疮(cSLE)抗核抗体(ANA)及抗核抗体谱(ANAs)检出情况。运用聚类分析方法探索ANAs的聚类现象及其与临床表现的相关性。方法对2016年1月至2023年8月在聊城市人民医院小儿肾脏风湿免疫科入院的cSLE患者的临床资料进行回顾性分析。基于ANA及ANAs检出情况,运用系统聚类方法进行聚类分析并比较各聚类实验室检查及临床特征的差异。结果50例cSLE患者ANA均为阳性;共检出自身特异性抗体256例,总阳性率30.118%,其中阳性率最高的为抗ds-DNA抗体。通过系统聚类分析,50例cSLE患儿呈现3个聚类特征,即聚类1(C1),以抗ds-DNA、Nukleosomen、Histone抗体高阴性率,抗Rib.P-Prot高阳性率为聚类特征;聚类2(C2),以抗SSA、RO-52抗体高阳性率为聚类特征;聚类3(C3),以抗Sm抗体、抗nRNP/Sm抗体高阳性率,抗RO-52抗体高阴性率为聚类特征。C3的24 h尿蛋白定量及尿素氮水平高于C1和C2,差异有统计学意义(P<0.05);补体C4水平在C2中低于C1、C3,差异有统计学意义(P<0.05);关节炎、淋巴结炎、神经病变、浆膜炎、狼疮性肾炎、高血压、血液系统受累、干眼的发生率在3组聚类中比较,差异有统计学意义(P<0.05)。结论系统性红斑狼疮患儿ANAs具有一定的聚类现象,且不同的聚类特征同其临床表现具有一定相关性。Objective To analyze the detection of antinuclear antibodies(ANA)and antinuclear antibody spectrum(ANAs)in 50 cases of pediatric systemic lupus erythematosus(cSLE).Clustering analysis was applied to explore the clustering phenomenon of ANAs and their correlation with clinical manifestations.Methods A retrospective analysis of the clinical data of cSLE patients admitted to the Department of Pediatric Nephrology and Rheumatology and Immunology,Liaocheng People's Hospital from January 2016 to August 2023 was conducted.Based on the detection of ANA and ANAs,a systematic clustering method was used to perform clustering analysis,and to compare differences in laboratory tests and clinical characteristics across clusters.Results All 50 cSLE patients tested positive for ANA.A total of 256 cases of specific autoantibodies were detected with a positive rate of 30.118%,the highest positive rate was anti-ds-DNA antibodies.Systematic clustering analysis showed three clustering characteristics in the 50 cases of cSLE children:cluster 1(C1)was characterized by high negative rates of anti-ds-DNA,Nukleosomen,and Histone antibodies and a high positive rate of anti-Rib.P-Prot antibodies;cluster 2(C2)was characterized by high positive rates of anti-SSA and RO-52 antibodies;cluster 3(C3)was characterized by high positive rates of anti-Sm antibodies and anti-nRNP/Sm antibodies and high negative rates of anti-RO-52 antibodies.The 24-hour urine protein quantification and urea nitrogen levels were higher in C3 than in C1 and C2,with statistically significant differences(P<0.05).Complement C4 levels were lower in C2 than in C1 and C3,with statistically significant differences(P<0.05).There was a significant difference in the incidence of arthritis,lymphadenitis,neuropathy,serositis,lupus nephritis,hypertension,blood system involvement,and dry eyes differed among the three clusters(P<0.05).Conclusion The ANAs in pediatric systemic lupus erythematosus exhibit some clustering phenomena,and different clustering characteristics are correlated w

关 键 词：儿童系统性红斑狼疮 抗核抗体 抗核抗体谱 聚类分析 

分 类 号：R593.24[医药卫生—内科学]