抗核糖体P蛋白抗体在儿童系统性红斑狼疮中的临床价值  

The clinical value of anti-ribosomal P protein antibody in childhood systemic lupus erythematosus

作　　者：闫红[1] 贾永萍 张晓双 马德冉[1] 郭映辉[1] YAN Hong;JIA Yong-ping;ZHANG Xiao-shuang;MA De-ran;GUO Ying-hui(Department of Clinical Laboratory,Hebei Children′s Hospital,Shijiazhuang 050031,China)

机构地区：[1]河北省儿童医院检验科,河北石家庄050031

出　　处：《河北医科大学学报》2025年第4期424-429,共6页Journal of Hebei Medical University

基　　金：河北省医学科学研究课题计划项目(20231129)。

摘　　要：目的探讨抗核糖体P蛋白(anti-ribosomal P protein,Rib)抗体在儿童系统性红斑狼疮(childhood onset systemic lupus erythematosus,cSLE)中的临床价值。方法回顾性分析2019年4月—2023年12月于河北省儿童医院收治的初治cSLE患儿(cSLE病例组)125例,非SLE风湿病患儿(疾病对照组)86例和健康对照者62例的临床资料。比较抗Rib抗体及其他自身抗体单独和联合检测诊断cSLE的敏感度和特异度,比较各组间抗Rib抗体等自身抗体阳性率。应用Logistic回归分析cSLE组敏感度较高的自身抗体与cSLE的发生之间的关系。进一步比较抗Rib抗体阳性组和阴性组cSLE患儿在临床特征、实验室指标的差异。结果cSLE组抗Rib抗体敏感度为47.2%,明显高于疾病对照组及健康对照组,抗核小体+抗Sm+抗dsDNA+抗Rib抗体联合检测的敏感度为82.4%,明显高于单项检测及抗核小体+抗Sm+抗dsDNA的敏感度。抗dsDNA和抗Rib抗体阳性是患cSLE的独立危险因素(P<0.05)。cSLE组中抗Rib阳性组淋巴结肿大和皮肤黏膜损害(皮疹、脱发)的发生率、抗核小体和抗组蛋白的阳性率明显高于抗Rib阴性组,差异有统计学意义(P<0.05)。结论抗Rib抗体可能参与了cSLE的发病机制,是患cSLE的独立危险因素,其联合抗dsDNA、抗Sm等自身抗体,对cSLE的诊断有重要意义;抗Rib抗体阳性时cSLE患儿淋巴结肿大、皮肤黏膜损害的发生率更高,其与抗核小体、抗组蛋白抗体存在一定关联。Objective To investigate the clinical value of anti-ribosomal P protein(Rib)antibody in childhood systemic lupus erythematosus(cSLE).Methods A retrospective analysis was performed on clinical data from 125 patients with newly diagnosed cSLE(cSLE group)from Apirl 2019 to December 2023 in Hebei Children′s Hospital,86 patients with non-SLE rheumatic disease(disease control group),and 62 healthy controls.The sensitivity and specificity of anti-Rib antibody and other autoantibodies alone and in combination in the diagnosis of cSLE were compared.The positivity rates of anti-Rib antibodies and other autoantibodies among different groups were compared.Logistic regression analysis was used to analyze the relationship between the high sensitivity of autoantibodies and the occurrence of cSLE in cSLE group,and to further compare the clinical characteristics and laboratory indexes of cSLE children in the positive anti-Rib antibody group and the negative group.Results The sensitivity of anti-Rib antibody in cSLE group was 47.2%,which was significantly higher than that of disease control group and healthy control group.The sensitivity of anti-nucleosome+anti-Sm+anti-dsDNA+anti-Rib antibody for combined detection was 82.4%,which was significantly higher than that of single detection and anti-nucleosome+anti-Sm+anti-dsDNA.Anti-dsDNA and positive anti-Rib antibodies were independent risk factors for cSLE(P<0.05).In cSLE group,the incidence of lymph node enlargement and skin mucosal damage(rash,hair loss),as well as the positivity rates of anti-nucleosome and anti-histone antibodies,was significantly higher in the positive anti-Rib antibodies group than in the negative anti-Rib antibodies group,suggesting significant difference(P<0.05).Conclusion Anti-Rib antibody may be involved in the pathogenesis of cSLE and is an independent risk factor for cSLE.Combined with anti-dsDNA,anti-Sm and other autoantibodies,it is of great significance for the correct diagnosis of cSLE.When anti-Rib antibody is positive,the incidence of lymph node

关 键 词：红斑狼疮 系统性 儿童 抗核糖体P蛋白抗体 

分 类 号：R593.241[医药卫生—内科学]