汉族多发性肌炎/皮肌炎患者抗合成酶抗体谱及其临床意义

Profile and Clinical Significance of Anti-aminoacyl-tRNA Synthetase Antibodies in Han-Chinese Patients with Polymyositis/dermatomyositis

目的探讨汉族多发性肌炎皮肌炎(polymyositisdermatomyositis,PMDM)患者抗合成酶(aminoacyl-transfer RNA synthetase,ARS)抗体谱的分布及其临床意义。方法采用核酸免疫沉淀法对145例汉族PMDM患者进行抗ARS抗体检测,并收集阳性患者临床资料。采用t检验、Mann-Whitney U检验、χ2检验或Fisher’s精确概率法进行统计学分析。结果 145PMDM例患者中,40例(27.6%)抗ARS抗体阳性,其中抗Jo-1抗体阳性24例,非Jo-1抗ARS阳性16例(包括抗EJ 7例、抗OJ 5例、抗KS 3例和抗PL-12抗体1例)。抗Jo-1抗体阳性组中PM比例高于非Jo-1抗ARS阳性患者组,差异有统计学意义(87.5%vs.43.8%,P=0.003);但2组性别和发病年龄分布类似;发热、雷诺现象、关节痛、技工手、间质性肺疾病和吞咽困难发生率及肌酸激酶水平在抗Jo-1抗体组[分别为54.2%、16.7%、25.0%、33.3%、91.7%、4.2%和(3 041±4 351)UL]和非Jo-1抗ARS组[分别为43.8%、31.3%、37.5%、25.0%、100.0%、18.8%和(861±820)UL]间差异无统计学意义(P>0.05)。结论汉族PMDM患者非Jo-1抗ARS抗体并不少见,其临床表现与抗Jo-1抗体阳性患者相似。

Objective To explore the profile and clinical significance of anti-aminoacyl-tRNA synthetase （anti- ARS） antibodies in HaM-Chinese patients with polymyositis/dermatomyositis （PM/DM）. Methods Sera collected from 145 HaM-Chinese patients with PM/DM were investigated for anti-ARS antibodies by RNA- immunoprecipitation （RNA-IP） . Clinical data of antibody-positive patients were collected from medical records. Statistical analyses were performed using t test, Mann-Whitney U test, Chi square test or Fisher＇ s exact test. Results Anti-ARS antibodies were detected in 40 （27. 6% ） patients by RNA-IP. Twenty four patients were positive for anti-Jo-1 and 16 patients were positive for non-Jo-1 anti-ARS （7 anti-EJ, 5 anti- OJ, 3 anti-KS, and 1 anti-PL-12 ）. The frequency of PM in anti-Jo-1 positive patients was significantly higher than that in non-Jo-1 anti-ARS positive patients （87. 5% vs. 43.8%, P = 0. 003 ）. The distribution of sex and age at disease onset were similar between anti-Jo-l-positive and non-Jo-1 anti-ARS-positive patients. The frequencies of fever, Raynaud phenomenon, arthralgia, mechanic＇ s hands, interstitial lung disease, dysphagia and the levels of creatine kinase were comparable between anti-Jo-l-positive patients [54.2%, 16.7%, 25.0%, 33.3%, 91.7%, 4.2%, and （3 041±4 351） U/L, respectively ] and non-Jo-1 anti-ARS-positive patients [43.8%, 31.3%, 37.5%, 25.0%, 100. 0%, 18.8%, and （861± 820） U/L, respectively]. Conclusion Non-Jo-1 anti-ARS antibodies are not rare in Han-Chinese patients with PM/DM. The clinical characteristics are similar between anti-Jo-l-positive and non-Jo-I anti-ARS- positive patients.