系统性硬化症患者PM-Scl抗体检测的临床意义

Clinical significance of PM-Scl antibody detection in systemic scleroderma

目的分析并探讨系统性硬化症（SSc）患者血清多发性肌炎-硬化症（PM-Scl）抗体检测的临床意义。方法选取2009～2012年通过典型临床表现或皮肤病理活检确诊为SSc的315例住院患者,根据自身抗体谱表达不同,分为PM-Scl抗体阳性（PM-Scl＋）组90例、Scl-70抗体阳性（Scl-70＋）组70例、抗着丝点抗体阳性（ACA＋）组75例和抗体阴性组80例,分析并比较各组患者皮肤及内脏损害严重程度。结果 PM-Scl＋组临床表现多样,肌炎发生率与其他3组比较较明显升高（P〈0.05）;Scl-70＋组内脏器官损害发生率比PM-Scl＋组高（均P〈0.05）;ACA＋组皮肤色素加深、雷诺现象、毛细血管扩张发生率比PM-Scl＋组高,而肺间质、心脏、肾脏损害发生率降低（均P〈0.05）。结论对SSc患者血清PM-Scl抗体表达水平的分析,有助于加深临床医师对SSc常见自身抗体的理解,并作出正确的病情评估。

Objective To analyze and discuss the expression of serum polymyositis‐scleroderma（PM‐Scl） antibody and its clinical significance in patients with systemic scleroderma（SSc） .Methods 315 hospitalized patients diagnosed with scleroderma by typical clinical manifestations or skin pathology from 2009 to 2012 were enrolled in the study .All patients were grouped into PM‐Scl antibody positive（PM‐Scl ＋ ） group（90 cases） ,Scl‐70 antibody positive（Scl‐70＋ ） group（70 cases） ,anti‐centromere antibody positive（ ACA＋ ） group（75 cases） and antibody negative group（80 cases） according to autoantibody spectrum .The severity of skin and visceral damage among all the groups were analyzed and compared .Results Patients in PM‐Scl＋ group were characterized with different clinical manifestations .Compared with the other 3 groups ,the incidence of myositis in PM‐Scl＋ group was significantly higher（ all P〈 0 .05） ;patients in Scl‐70＋ group had higher incidence of visceral organ damage than PM‐Scl＋ group（all P 〈 0 .05） .The incidence of skin lesions ,Raynaud′s phenomenon and capillary expansion in ACA＋ group were higher than that of PM‐Scl＋ ,while the incidence of interstitial lung disease ,heart disease and kidney disease were lower（all P〈 0 .05） .Conclusion It is helpful for clinicists′ further understanding of common autoantibodies in Ssc patients and making correct assessment of the disease through analyzing the expression of PM‐Scl antibody .