摘要
目的探讨抗Ro-52抗体阳性的特发性炎性肌病(IIMs)患者的临床及免疫学特征。方法本研究为回顾性研究,选取2016年1月至2021年12月北部战区总医院风湿免疫科收治的110例IIMs患者,男37例,女73例,年龄(52.14±15.16)岁,年龄范围为21~83岁。收集患者的临床资料和实验室指标。结果110例IIMs患者中,抗Ro-52抗体阳性者28例,抗Ro-52抗体阴性者82例,将所有患者根据抗Ro-52抗体的阳性情况分成阳性组与阴性组。阳性组患者的女性[85.7%(24/28)]占比高于阴性组[59.8%(49/82)],间质性肺疾病(ILD)患病率[64.3%(18/28)]高于阴性组[30.5%(25/82)],"技工手"比例[21.4%(6/28)]高于阴性组[6.1%(5/82)],颈前"V"型疹或披肩征发生率[10.7%(3/28)]低于阴性组[31.7%(26/82)],活动后气短者比例[28.6%(8/28)]高于阴性组[8.5%(7/82)],差异均有统计学意义(P<0.05)。阳性组血红蛋白、血清白蛋白水平低于阴性组,抗核抗体阳性率、抗合成酶抗体(ARS)阳性率、血清肌酸激酶、血清乳酸脱氢酶、丙氨酸转氨酶、天冬氨酸转氨酶、免疫球蛋白G、免疫球蛋白A、免疫球蛋白M水平均高于阴性组,差异均有统计学意义(P<0.05)。阳性组患者中,抗MDA5抗体阳性3例、抗HMGCR抗体阳性1例、ARS阳性15例;阴性组患者中,抗MDA5抗体阳性2例、抗TIF-1γ抗体阳性1例、抗NXP-2抗体阳性1例、抗Mi-2抗体阳性1例、抗SRP抗体阳性2例、ARS阳性6例。结论抗Ro-52抗体可导致IIMs一系列不典型的临床表现,其多伴有抗核抗体阳性,抗Ro-52抗体阳性者应注意ARS综合征的可能,及早筛查ILD、肌酶水平和肌炎特异性抗体谱。
Objective To investigate the clinical and immunological characteristics of idiopathic inflammatory myopathies(IIMs)patients with positive anti-Ro-52 antibody.Methods This study was a retrospective study.A total of 110 patients with IIMs admitted to the department of Rheumatology and Immunology,General Hospital of Northern Theater Command from January 2016 to December 2021 were selected,including 37 males and 73 females,aged(52.14±15.16)years old,ranging from 21 to 83 years old.Clinical data and laboratory indicators were collected.Results Among 110 IIMs patients,28 were positive for anti-Ro-52 antibody and 82 were negative for anti-Ro-52 antibody,all patients were divided into positive group and negative group according to the positive status of anti-Ro-52 antibody.Positive group of patients with female[85.7%(24/28)]much higher than negative group[59.8%(49/82)],pulmonary interstitial disease prevalence rate[64.3%(18/28)]was higher than negative group[30.5%(25/82)].Mechanic hand[21.4%(6/28)]was higher than negative group[6.1%(5/82)],V type rash or anterior portion shawl rate[10.7%(3/28)]was lower than the negative group[31.7%(26/82)].The proportion of short breath after activity[28.6%(8/28)]was higher than that of negative group[8.5%(7/82)],and the differences were statistically significant(P<0.05).The levels of hemoglobin and albumin in the positive group were lower than those in the negative group,the positive rate of antinuclear antibodies,the positive rate of anti-aminoacyl-tRNA synthetase antibodies(ARS),the levels of creatine kinase,1actate dehydrogenase,alanine aminotransferase,aspartate amino transferase,immunoglobulin G,immunoglobulin A and immunoglobulin M were higher than those in the negative group,and the differences were statistically significant(P<0.05).In the positive group,anti-MDA5 antibody was positive in 3 patients,anti-HMGCR antibody was positive in 1 patient,and ARS was positive in 15 patients.In the negative group,anti-MDA5 antibody was positive in 2 patients,anti-TIF-1γantibody was positi
作者
郭雪美
李萍
郭琳
李亚娣
熊楚辉
高雅
叶雨萌
Guo Xuemei;Li Ping;Guo Lin;Li Yadi;Xiong Chuhui;Gao Ya;Ye Yumeng(Department of Rheumatology and Immunology,General Hospital of Northern Theater Command,Shenyang 110000,China)
出处
《中国临床实用医学》
2022年第6期53-58,共6页
China Clinical Practical Medicine
