肌炎抗体对特发性炎性肌病的诊断价值

The diagnostic value of myositis antibodies on idiopathic inflammatory myopathies

目的探讨血清肌炎自身抗体对特发性炎性肌病(IIM)患者的诊断价值。方法采用线性免疫印迹法(LIA)检测225份血清标本肌炎自身抗体,筛选出阳性标本87例,观察不同疾病组肌炎抗体的阳性分布。对比分析各组单项和多项抗体阳性检出率。结果多发性肌炎(PM)组肌炎特异性自身抗体(MSAs)阳性率最高的为抗信号识别颗粒(SRP)抗体(22%);抗Mi-2抗体阳性的只检出1例,分布于皮肌炎(DM)组;抗合成酶抗体综合征(ASS)组MSAs阳性率最高的为抗Jo-1抗体(70%),与其它各组相比差异有统计学意义(P<0.05)。PM/DM组两个及以上抗体阳性的检出率分别为31.5%、35.7%,且均伴有抗Ro52抗体。ASS组两个及以上抗体同时阳性的检出率(70%)明显高于单项抗体检出率,差异具有统计学意义(P<0.05)。结论肌炎抗体的联合检测对IIM的诊断和临床分型具有重要价值。

Objective To investigate the diagnostic value of serum myositis autoantibodies on idiopathic inflammatory myopathy(IIM).Methods The myositis autoantibodies in 225 serum samples were detected by linear immunoblotting assay(LIA),in which,87 positive samples were screened out and the positive distribution of myositis antibodies in different disease groups was observed.The positive rates of single and multiple antibodies in each group were compared.Results The highest positive rate of myositis specific autoantibodies(MSAs)in the polymyositis(PM)group was the anti-signal recognition granule(SRP)antibody(22%);Only 1 case was positive for anti Mi-2 antibody,which was distributed in dermatomyositis group;The highest positive rate of MSAs in the anti-synthetase syndrome(ASS)group was anti-Jo-1 antibody(70%),and the difference was statistically significant compared with the other groups(P<0.05).The positive rates of two or more antibodies in PM/DM group were 31.5%and 35.7%,respectively,and were accompanied by anti-Ro52 antibody.The positive rate of two or more antibodies in ASS group was significantly higher than that in single antibody group(P<0.05).Conclusion Combined detection of myositis antibodies is of great value in the diagnosis and clinical typing of IIM.