干燥综合征患者血清自身抗体检测结果及临床意义

Clinical significance of autoantibodies in Sj（o）gren syndrome （SS） diagnosis

目的 评价抗SSa抗体、抗SSb抗体、抗核抗体（ANA）和抗RNP/Sm抗体等自身抗体联合检测对干燥综合征（SS）诊断的价值.方法 分别检测155例SS患者和124例其他结缔组织病患者血清中抗SSa抗体、抗SSb抗体、ANA和抗nRNP/Sm抗体等相关自身抗体阳性检出情况进行比较分析.结果 SS组的抗SSa抗体、抗SSb抗体和抗nRNP/Sm抗体的阳性检出率为69.0%、45.1%和76.1%,远高于非SS组41.9%、17.7%和57.3%（P＜0.05）,SS组的ANA、抗CENP B和抗AMA-M2的阳性检出率高于非SS组,但差异无统计学意义（P ＞0.05）,其余自身抗体均是SS组的阳性检出率低于非SS组,除抗Jo-1外两组间差异均有统计学意义（均P＜0.05）.抗SSa抗体的敏感度和特异度别为69.0%和39.1%,联合检测后,敏感度减少为43.9%,但特异度提高到89.7%.结论 SS患者血清中可出现抗SSa抗体、抗SSb抗体等特异性抗体,联合检测灵敏度低,但特异性增强,至于采用单项抗体筛查,还是联合检测结果,临床医生应根据具体病情所处的阶段进行具体分析判断.

Objective To evaluate autoantibodies including antiSSa antibody, antiSSb antibody, antinuclear antibody （ANA）and anti RNP antibody in Sjogren syndrome （SS） diagnosis. Methods Autoantibodies in 155 the SS patients ,124 other connective tissue disease patients（CTD） in Tongde Hospital of Zhejiang Province and the First Hospital affiliated the Medical College, Zhejiang Univeristy, from January 2006 to September 2010, including antiSSa antibody, antiSSb antibody, antinuclear antibody（ ANA ）and anti RNP/Sm antibody were detected. And the positive rate of autoantibodies were compared. Results Positive rate of antiSSa antibody, antiSSb antibody, and anti RNP/Sm antibody were 69.0%,45.1%和 76.1% in the SS patients ,and were higher than those in other CTD patients （41.9%, 17.7%和57.3%,respectively） （P 〈 0.05 ）. Positive rate of antinuclear antibody （ANA）, antiCENP B antibody ,and antiAMA-M2 antibody were higher in SS patients than those in other CTD patients ,but there were no significantly different （P 〉0.05 ）. Positive rate of other autoantibodies in SS patients were significantly lower than in other CTD patients （P 〈0.05）,but Jo-1 antibody. Sensitivity and specificity of antiSSa antibody were 69.0% and 39. 1%, but they were 43.9% and 89.7% using association detection. Conclusion There are antiSSa antibody, antiSSb antibody in serum of the SS patients. And association detection can reduce the sensitivity and improve the specificity of SS.