原发性胆汁性肝硬化及干燥综合征抗SSA抗原表位抗体的检测及临床分析

Research of SSA epitopes in patients of primary biliary cirrhosis and primary Sjiigren＇s syndrome

目的探讨原发性胆汁性肝硬化（PBC）、原发性干燥综合征（pSS）和PBC合并干燥综合征（SS）3组患者抗60000SSA多倍体寡肽抗原表位（MAPs）抗体阳性率的差异。方法人工合成60000SSA的MAPs，酶联免疫吸附试验（EUSA）检测PBC、pSS和PBC合并sS3组患者的抗MAPs抗体，比较各组抗MAPs抗体阳性率的差异，并分析各抗MAPs抗体与临床症状的关系。采用，检验、Fisher精确检验、t检验或Wilcoxon秩和检验进行统计分析。结果抗MAP20抗体阳性率在pss与PBC合并SS组间差异有统计学意义[分别为25％（7／28），0（0／25）；X2=7．2011，P=0．0073]，PBC合并ss组抗MAP3、MAP7、MAPl7抗体检测的阳性率[分别为4％（1／25），4％（1／25），8％（2／25）]类似pss组[分别为4％（1／28），7％（2／28），7％（2／28％）]。在有脾大的患者中抗MAP7抗体及抗MAPl2抗体阳性率明显高于无脾大的患者[分别为38％（3，8）和2％（2／84），38％（3，8）和4％（3，84）；P=0.0394，P=0．0394]，有涎腺损害的患者中抗MAPl7抗体阳性率显著低于无涎腺损害的患者[分别为5％（3／64）和39％（5／13）；X2=4．4318，P=0．0353]。结论PBC、pSS和PBC合并ss3组患者的抗60000SSA抗原表位的抗体谱存在差异，某些抗MAPs抗体阳性率在具有特定临床表现的患者中较高。

Objective To analyze the difference between primary biliary cirrhosis （PBC） and primary Sj6gren＇s syndrome （pSS） and primary biliary cirrhosis complicating with Sjsgren＇s syndrome （SS） in clinical features, anti-（g） 000 SSA multiple antigenic peptides （MAPs） detection rate, and explore the potential mechanisms of PBC with SS. Methods MAPs were artificially synthesized. Enzyme-linked immunosorbent assay （ELISA） was done to detect anti-MAPs antibodies in the sera of the three groups of patients. The detection rates of anti-MAPs antibodies were compared among groups and the relations of anti-MAPs antibodies with clinical features were analyzed. Chi-square test, Fisher＇s exact test, t test or Wilcoxon signed rank test were conducted in this study. Results There was no significant difference in clinical features, liver function tests and antibody profiles between PBC and PBC with SS. Significant difference of anti-MAF20 antibody detection rate was detected between pSS and PBC with SS groups [25%（7/28） vs 0（0/25）, X2=7.201 1, P= 0.007 3], and anti-MAP3, 7 and 17 antibody detection rates in PBC with SS patients [4%（1/25）, 4%（1/25）, 8%（2/25） ] were similar to pSS [4%（1/28）, 7%（2/28）, 7%（2/28） ]. The anti-MAP7 antibody and anti-MAP12 antibody detection rates were significantly higher in patients with splenomegaly than patients without splenomegaly [38%（3/8） vs 2%（2/84）, 38%（3/8） vs 4%（3/84）; P=0.039 4, P=0.039 4], while the anti- MAP17 antibody detection rate Was signifieantly lower in patients with salivary gland injury than patients without salivary gland injury [5%（3/64） vs 39%（5/13）; X2=4.431 8, P=0.035 3]. Coneittsion There is significant difference in the anti-MAPs detection rates among the three patients groups, and the detection ratemay be higher in patients with certain clinical manifestations.