抗核糖体P蛋白抗体在新疆青少年系统性红斑狼疮中临床意义

The clinical value of ribosomal P antibodies in juvenile systemic lupus erythematosus patients in Xinjiang

目的探讨抗核糖体P蛋白抗体(Ribosomal Pantibodies,anti-P)在新疆青少年系统性红斑狼疮(Ju-venile SLE)患者中的临床意义。方法无选择性连续收集2007—2012年79例青少年系统性红斑狼疮患者,其中34例anti-P阳性和45例anti-P阴性青少年SLE患者,两组进行前瞻性病例对照研究,分析比较两组临床特征、自身抗体和治疗方面的差异。结果与anti-P阴性组相比,anti-P阳性组患者发病时年龄较小,关节炎和神经精神狼疮(Neuropsychiatric SLE,NPSLE)的发生率明显升高,差异具有统计学意义(P<0.05),anti-P阳性组患者病情活动指数高于anti-P阴性组,差异具有统计学意义(P<0.05)。与anti-P阴性组相比,anti-P阳性组患者血清中抗aCL抗体阳性率较高(P<0.05)。两组种族、性别、狼疮肾炎及其他临床表现和自身抗体比较,差异无统计学意义(P>0.05)。Anti-P阳性组患者环磷酰胺使用率高于anti-P阴性组(P<0.05)。NPSLE患者主要表现为认知障碍(59.1%)和头痛(50.0%),其次为癫痫(36.4%)和抑郁状态(27.3%)。Anti-P阳性组患者认知障碍和抑郁发生率高于anti-P阴性组,但差异无统计学意义(P>0.05)。结论新疆地区anti-P阳性的青少年SLE患者发病年龄偏小,临床上更易出现关节炎和神经精神狼疮,病情活动度高,多伴有aCL抗体阳性,更多患者使用环磷酰胺治疗。

Objective To describe the clinical and diagnostic value of ribosomal P antibodies （antl-P） in a cohort of juvenile systemic lupus erythematosus （SLE） patients in Xinjiang. Methods Seventy-nine con-secutive unselected juvenile SLE patients in our hospital from 2007 to 2012 were recruited prospectively and compared between with anti-P groups and without anti-P groups. Results The patients with anti-P showed a much higher prevalence of arthritis, neuropsychiatric SLE （NPSLE）, aCL and more active dis-ease activity （P 〈0.05）. The anti-P antibodies were more frequently observed in younger patients （P 〈0. 05）. However, anti-P antibodies were not associated with ethnic, gender, lupus nephritis or others clinical features and auto antibodies. More patients were receiving cyclophosphamide in group with anti-P antibod-ies （P 〈0.05）. Cognitive dysfunction （59.1%） and headache （50.0%） were more frequently observed in NPSLE. Second, seizure disorder and depression disorder were 36.4% and 27.3%, respectively. Anti-P antibodies were more frequently observed in patients with cognitive dysfunction and depression, but there were not statistically different between two groups （P 〉0.05）. Conclusion This study revealed a higher prevalence of anti-P antibodies was in younger juvenile SLE. It supports the anti-P antibody association with arthritis, NPSLE and disease activity as well as the presence of aCL. The patients with anti-P anti-body had more positive in therapy.