原发性干燥综合征患者免疫指标的检测分析-中国病原生物学杂志.DOC

原发性干燥综合征患者免疫指标的检测分析 任艳玲 赵剑波 尹芳蕊 张文兰 王占黎 王永福 包头医学院风湿免疫研究所 邮编：014010 摘要：目的 分析原发性干燥综合征患者自身抗体等免疫指标的变化，为原发性干燥综合征的临床诊断提供依据。方法 采用间接免疫荧光法和免疫印记法检测抗核抗体和可溶性核提取物，免疫比浊法检测免疫球蛋白和C反应蛋白,对各项结果进行统计分析。结果 原发性干燥综合征患者145例，男12例，女133例，平均年龄45.27±12.50岁（28-79岁）；抗核抗体阳性率在干燥综合征组、类风湿关节炎组、健康体检组分别为86.7%、79.4%、19% ；SSA阳性率在干燥综合征组、类风湿关节炎组、健康体检组分别为63.3%、16.5%、4%，SSB阳性率在干燥综合征组、类风湿关节炎组、健康体检组分别为36%、2.4%、1%，SSA/SSB阳性率在干燥综合征组、类风湿关节炎组、健康体检组分别为31.03%、2.4%、1% ，IgG平均水平在干燥综合征组、类风湿关节炎组、健康体检组分别为37.48±8.26g/L、29.67±6.43g/L、10.21±5.87g/L。结论 干燥综合征检测项目中 SSA、SSB、 SSA /SSB检测对干燥综合征具有较强的特异性, 在其他结缔组织病表达较少,结合IgG异常升高对诊断干燥综合征更具有指导作用。 关键词：原发性干燥综合征 抗核抗体谱 SSA SSB 免疫球蛋白 Abstract：Objective To provide guide for the clinical diagnosis of the primary Sj?grens Syndrome (PSS), autoantibody biomarkers of patients with PSS were analyzed. Methods 372 patients were included in the study: a control group (n = 100), a group of patients with PSS (PSS, n = 145) and a group of patients with Rheumatoid arthritis (RA, n=127). Indirect immunofluorescence and Western blot were used to detect the levels of ANA and ENA. Immunoturbidimetry was used to measure the content of immune globulin (IgG) and C reactive protein. Results The positive rates of the autoantibodies against Ro (SSA) , the autoantibodies against La (SSB) and SSA /SSB in patients with PSS (63.3%, 36% and 31.03%, respectively) were significantly higher than those in patients with RA (16.5%, 2.4% and 2.4%, respectively) and in healthy controls (4%, 1% and 1%, respectively). The levels of IgG in the PSS group, the RA group and the control group were 37.48±8.26g/L, 29.67±6.43g/L and 10.21±5,87g/L, respectively. Moreover, the positive rate of ANA in the PSS group, the RA group and the control group were 86.7%, 79.4% and 19%, respectively. Conclusion SSA、SSB、 SSA /SSB has high specificity to detect PSS. Moreover, high levels of SSA、SSB、 SSA /SSB together with abnormal IgG may improve the diagnostic level of PSS. Keywords: primary Sj?grens Syndrome (PSS), antinuclear antibody (ANA),