抗Ro52抗体阳性的抗合成酶综合征患者的临床特征分析

Clinical characteristics of patients with antisynthetase syndrome and positive anti-Ro52 antibody

分析抗Ro52抗体阳性的抗合成酶综合征(ASS)患者的临床特征。收集2017年至2020年郑州大学第一附属医院风湿免疫科和呼吸科住院确诊的203例ASS患者,回顾性分析其一般资料、临床表现、实验室检查等。203例ASS患者中男55例,女148例,ASS发病年龄(51.9±13.3)岁。抗Ro52抗体阳性者163例,抗Ro52抗体阴性者40例。与抗Ro52抗体阴性者比,抗Ro52抗体阳性者中女性多见[77.3%(126/163)比55.0%(22/40),P=0.004],ASS确诊时病程中位时间较长[4.5(2,24)个月比2(1,12)个月,P=0.024],间质性肺病发生率更高[96.9%(158/163)比65.0%(26/40),P<0.001],关节炎[33.7%(55/163)比17.5%(7/40),P=0.046]及关节痛[39.3%(64/163)比20.0%(8/40),P=0.022]更多见,抗核抗体阳性率更高[85.3%(139/163)比55.0%(22/40),P<0.001],抗Jo-1抗体阳性率[32.5%(53/163)比50.0%(20/40),P=0.039]、白蛋白[(34.6±5.2)g/L比(37.3±4.7)g/L,P=0.004]、外周血淋巴细胞计数[(1.4±0.8)×10^(9)/L比(1.8±0.8)×10^(9)/L,P=0.014]较低。抗Ro52抗体阳性的ASS患者表现出特殊的临床亚型,更易出现间质性肺病、关节炎、关节痛、抗核抗体阳性、低白蛋白水平及低外周血淋巴细胞计数。

To analyze the clinical characteristics of patients with antisynthetase syndrome(ASS)and positive anti-Ro52 antibody.The clinical data of 203 ASS patients admitted to the First Affiliated Hospital of Zhengzhou University from 2017 to 2020 were analyzed retrospectively.Demographics,clinical manifestations,laboratory results,treatment and outcome were collected including data of 18 patients with rapidly progressive interstitial lung disease(RP-ILD).In total,the majority were women(148,72.9%).The average onset age was(51.9±13.3)years.There were 163(80.3%)patients with positive anti-Ro52 antibody.The positivity in women(77.3%vs.55.0%,P=0.004)was higher,and the median time from disease onset to diagnosis[4.5(2.0,24.0)months vs.2.0(1.0,12.0)months,P=0.024]was longer in patients with positive anti-Ro52 antibody than those negative.Compared with negative patients,patients with positive anti-Ro52 antibody had a higher incidence of interstitial lung disease(ILD)(96.9%vs.65.0%,P<0.001),arthritis(33.7%vs.17.5%,P=0.046),and arthralgia(39.3%vs.20.0%,P=0.022).Higher rate of positve antinuclear antibody(ANA)(85.3%vs.55.0%,P<0.001),lower rate of positive anti-Jo-1 antibody(32.5%vs.50.0%,P=0.039),lower albumin level[(34.6±5.2)g/L vs.(37.3±4.7)g/L,P=0.004]and lower lymphocyte counts[(1.4±0.8)×10^(9)/L vs.(1.8±0.8)×10^(9)/L,P=0.014]were more common in patients with positive anti-Ro52 antibody.The presence of anti-Ro52 antibody is associated with a particular phenotype of ASS,leading to common ILD,involvement of joints,high ANA positivity,low albumin and low lymphocyte counts.