抗Scl-70抗体与系统性硬化病临床特征的相关性研究

A retrospective study on the relationship between autoantibody anti-Scl-70 and clinical features of systemic sclerosis

目的:探讨抗Scl-70抗体与系统性硬化病(SSc)临床特征的相关性。方法:回顾性分析1990年1月—2018年2月该院142例SSc住院患者资料,包括性别、年龄、临床表现和实验室检查等。采用IBM SPSS Statistics 23.0软件对抗Scl-70抗体阳性和抗Scl-70抗体阴性SSc患者临床特征的差异进行统计分析。结果:本研究中抗Scl-70抗体阳性SSc患者72例(50.7%),抗Scl-70抗体阴性者70例(49.3%)。与阴性组比较,阳性组中弥漫型SSc患者更多(70.8%vs.44.3%),SSc分类评分更高[(14.63±2.27)分vs.(11.40±2.72)分],起病至确诊间隔时间更短[12.0(18.0)个月vs.12.0(28.0)个月],更容易并发间质性肺病(ILD)(48.6%vs.20.0%),平均住院天数更短[(12.51±7.45)d vs.(17.71±17.89)d],差异均有统计学意义(P<0.05)。抗Scl-70抗体滴度越高,患者SSc分类为弥漫型SSc的可能性越大(P<0.05),并发ILD的概率也越大(P<0.05)。抗Scl-70抗体滴度与SSc分类评分、抗核抗体(ANA)阳性率、红细胞沉降率(ESR)、C反应蛋白(CRP)、补体C4、低密度脂蛋白胆固醇(LDL-C)及血小板(PLT)值均呈正相关(P<0.05)。抗Scl-70抗体滴度与住院天数、抗核糖核蛋白(RNP)/Sm抗体、抗Ro52抗体、抗多发性肌炎硬皮病抗体(PM-Scl)、抗着丝点蛋白B(ACA)抗体、抗增殖细胞核抗原(PCNA)抗体、核小体、组蛋白、线粒体M2阳性率,白蛋白(ALB)及高密度脂蛋白胆固醇(HDL-C)值均呈负相关(P<0.05)。结论:抗Scl-70抗体与弥漫型SSc和ILD密切相关。抗Scl-70抗体阳性患者SSc分类评分更高,起病至确诊间隔时间更短及平均住院天数更短。

Objective:To study the correlation between anti-Scl-70 antibody and clinical features of systemic sclerosis(SSc).Methods:The clinical data(including sex,age,clinical presentation,and laboratory examination)of 142 SSc patients hospitalized in the Second Affiliated Hospital of Kunming Medical University from January 1990 to February 2018 were reviewed.IBM SPSS Statistics 23.0 software was used to perform statistical analysis on the differences in clinical characteristics between anti-Scl-70 antibody positive group and anti-Scl-70 antibody negative group.Results:There were 72 cases(50.7%)of SSc patients positive for anti-Scl-70 antibody and 70 cases(49.3%)negative for anti-Scl-70 antibody.Compared with anti-Scl-70 antibody negative group,anti-Scl-70 antibody positive group had more cases of diffuse cutaneous SSc(70.8%vs.44.3%),higher SSc classification scores[(14.63±2.27)vs.(11.40±2.72)],and shorter interval from onset to diagnosis[12.0(18.0)months vs.12.0(28.0)months].Interstitial lung disease(ILD)was more likely to occur(48.6%vs.20.0%),and the average length of hospital stay was shorter[(12.51±7.45)days vs.(17.71±17.89)days](P<0.05).As anti-Scl-70 antibody titers increased,the patients were more likely to be classified as diffuse SSc(P<0.05),and to develop ILD(P<0.05).The titer of anti-Scl-70 antibody was positively correlated with SSc classification score,ANA positive probability,and the levels of ESR,CRP,complement C4,LDL-C,PLT(P<0.05).The titer of anti-Scl-70 antibody was negatively correlated with length of stay,the positive probability of anti-RNP/Sm,anti-Ro52,anti-PM-scl antibody,centromere protein B,PCNA,nucleosome,histone,mitochondria M2,and the levels of ALB and HDL-C(P<0.05).Conclusions:The anti-Scl-70 antibody is closely related to diffuse cutaneous SSc and ILD.The patients with positive anti-Scl-70 antibody have higher SSc classification score,shorter interval from onset to diagnosis,and shorter hospitalization days.