血清抗JO-1抗体检测的回顾性分析与临床价值探讨

Retrospective analysis and clinical value of serum anti-JO-1 antibody detection

目的研究抗JO-1抗体联合抗核抗体(ANA)以及实验室检测指标在临床诊断中的意义,为疾病的诊断提供参考和依据。方法选取2016-2018年来该院就诊的111例抗JO-1抗体阳性患者作为抗JO-1抗体(+)组,以400例抗JO-1抗体阴性患者作为抗JO-1抗体(-)组,就两组患者的一般资料、疾病诊断、ANA滴度和核型、抗可溶性抗原(ENA)抗体谱及其他实验室指标进行研究,并对结果进行统计学分析。结果抗JO-1抗体阳性患者男女比例为1∶1.78,且以中老年居多,平均55(47,68)岁,高于抗JO-1抗体(-)组,差异有统计学意义(P<0.05)。临床诊断为间质性肺炎(ILD)的病例最多(31.53%),其次为多发性肌炎/皮肌炎(PM/DM)(13.51%)、抗合成酶综合征(ASS)(11.71%)、肺部感染(11.71%),单独抗JO-1抗体阳性患者中肺部感染比例(16.07%)仅次于ILD(17.86%)。ANA核型以细胞质颗粒型为主。ENA谱中合并出现抗RO-52抗体阳性比例最高,达43.24%,差异有统计学意义(P<0.05)。抗JO-1抗体阳性患者肌酸激酶、血小板计数、C反应蛋白及细胞角蛋白19片段抗原均明显升高,差异有统计学意义(P<0.05)。结论抗JO-1抗体阳性患者以中老年女性为主,临床相关诊断主要为ILD、PM/DM、ASS,伴随部分疾病会出现相关实验室检测指标发生变化,联合ANA及实验室检测指标对疾病的诊断与鉴别诊断有重要意义。

Objective To study the clinical significance of anti-JO-1 antibody combined with anti-nuclear antibody(ANA)and other laboratory test indexes and to provide a reference for basic research and clinical diagnosis for the disease.Methods A total of 111 patients with positive anti-JO-1 antibody from 2016 to 2018 in the hospital were selected as anti-JO-1 antibody(+)group.400 patients with negative anti-JO-1 antibody were taken as the anti-JO-1 antibody(-)group.The general data,disease diagnosis,titer and karyotype of ANA,spectrum of anti-soluble antigen antibody(ENA)and other laboratory indicators of the two groups were statistically analyzed.Results The ratio of male to female patients with positive anti-JO-1 antibody was 1∶1.78,and the age was mostly middle-aged and elderly,with an average age of 55(47,68)years old,which was higher than that in the anti-JO-1 antibody(-)group,and the differences were statistically significant(P<0.05).The most cases were diagnosed as interstitial pulmonary disease(ILD,31.53%),followed by multiple myositis/dermatomyositis(PM/DM,13.51%),anti-synthase syndrome(ASS,11.71%)and pulmonary infection(11.71%).The proportion of pulmonary infection in patients with positive anti-JO-1 antibody alone(16.07%)was second only to ILD(17.86%).ANA karyotype was mainly cytoplasmic granule type.In the ENA spectrum,43.24%also showed positive anti-RO-52 antibodies,and the differences were statistically significant(P<0.05).Creatine kinase,platelet account,C rea ctive protein and CYFRA21-1 were significantly increased in patients with positive anti-JO-1 antibody,and the differences were statistically significant(P<0.05).Conclusion The majority of the patients with positive anti-JO-1 antibody were middle-aged and elderly women,and the clinical diagnoses were mainly ILD,PM/DM,ASS.Associated with some diseases,there will be changes in relevant laboratory test indexes.Combined ANA and laboratory test indexes are of great significance for the diagnosis and differential diagnosis of the disease.