抗PM-Scl抗体检测对结缔组织病重叠综合征的诊断和鉴别诊断价值

The value of anti-PM-Scl antibody detection in the diagnosis and differential diagnosis of overlap syndrome of connective tissue disease

目的探讨抗PM-Scl抗体检测对结缔组织病重叠综合征的诊断和鉴别诊断价值。方法采用酶联免疫吸附试验法对624例结缔组织病患者和100例体检健康者(对照组)血清进行抗PM-Scl抗体定量检测,采用间接免疫荧光法进行抗核抗体(ANA)检测,采用免疫印迹法进行ANA谱检测。结果624例结缔组织病患者抗PM-Scl抗体检出水平为6.57(2.31~10.02)RU/mL,检出率为3.5%;在90例多发性肌炎/系统性硬化症重叠综合征患者中,其抗体检出水平为11.34(6.48~16.32)RU/mL,其中有20例抗PM-Scl抗体水平明显升高,其检出水平为118.92(100.22~156.83)RU/mL,阳性率为22.2%(20/90)。多发性肌炎/系统性硬化症重叠综合征患者抗PM-Scl抗体水平和阳性率明显高于非多发性肌炎/系统性硬化症重叠综合征患者(P<0.01)。22例抗PM-Scl抗体水平升高患者ANA谱抗体检测阴性,用间接免疫荧光法筛查ANA,均为核仁抗体阳性。结论抗PM-Scl抗体主要出现在多发性肌炎/系统性硬化症重叠综合征患者中,抗体水平升高标志着重叠综合征的可能,有助于重叠综合征等结缔组织病的诊断和鉴别诊断。

Objective To explore the value of anti-PM-Scl antibody in the diagnosis and differential diagnosis of connective tissue disease.Methods The serum anti-PM-Scl of 624 patients with connective tissue disease and 100 healthy people(control group)were detected by enzyme-linked immunosorbent assay.The antinuclear antibody(ANA)was detected by indirect immunofluorescence and ANA spectrum was detected by Western blot.Results In 624 patients with connective tissue disease,the median detection level of anti-PM-Scl antibody was 6.57(2.31-10.02)RU/mL,with a median detection rate of 3.5%;in 90 patients with polymyositis/systemic sclerosis overlap syndrome,the median detection level of anti-PM-Scl antibody was 11.34(6.48-16.32)RU/mL,of which 20 patients had a significant increase in anti-PM-Scl antibody,with a median detection level of 118.92(100.22-156.83)RU/mL,with a detection rate of 22.2%(20/90).The level and detection rate of anti-PM-Scl antibody in patients with polymyositis/systemic sclerosis overlap syndrome were significantly higher than those in patients with non polymyositis/systemic sclerosis overlap syndrome(P<0.01).A total of 22 patients with increased anti-PM-Scl antibody level were negative in ANA spectrum antibody detection,and ANA was screened by indirect immunofluorescence method,all of them were positive in nucleolar antibody.Conclusion Anti-PM-Scl antibody mainly appears in the patients with polymyositis/systemic sclerosis overlap syndrome.The increase of antibody level indicates the possibility of overlap syndrome,which is helpful for the diagnosis and differential diagnosis of connective tissue diseases such as overlap syndrome.