IIF-SSS及BP180、BP230抗体检测在大疱性类天疱疮病情评估中的应用价值分析

Application Value of IIF⁃SSS and BP180/BP230 Antibody Assay in Evaluating the Severity of Bullous Pemphigoid

目的分析盐裂皮肤间接免疫荧光(IIF-SSS)及大疱性类天疱疮(BP)180、BP230抗体检测在BP病情评估中的应用价值。方法选取2018年7月至2020年7月郑州大学附属郑州中心医院收治的150例BP患者作为研究对象,收集患者就诊时及就诊后第30、60、180天的IIF-SSS滴度、BP180与BP230抗体水平、自身免疫性大疱性皮肤病严重程度评分(ABSIS)等资料,并根据皮损消退后6个月内是否复发将其分为复发组与非复发组,分析IIF-SSS滴度以及BP180、BP230抗体水平与ABSIS的相关性及对BP复发的预测价值。结果150例BP患者皮损消退后6个月内复发58例(38.67%),设为复发组;未复发92例(61.33%).设为未复发组。就诊后第30、60、180天,复发组患者IIF-SSS滴度、BP180与BP230抗体水平以及ABSIS均明显高于未复发组(就诊后第30天:t=4.256、2.828、2.894、2.612,P<0.001、P=0.005、P=0.004、P=0.010:就诊后第60天:t=3.959、10.080、5.312、3.182,P<0.001、P<0.001、P<0.001、P=0.002;就诊后第180天:t=2.928、12.240、17.020、8.575,P=0.004、P<0.001、P<0.001、P<0.001);Pearson相关性分析结果显示,IIF-SSS滴度以及BP180、BP230抗体水平与ABSIS均呈显著正相关性(r=0.215、0.243、0.196,P=0.008、0.003、0.016);受试者工作特征(ROC)曲线分析结果显示,IIF-SSS联合BP180、BP230抗体检测预测BP复发的曲线下面积(AUC)为0.826,敏感度为81.7%,特异度为78.8%结论IIF-SSS与BP180、BP230抗体检测能够有效评估BP患者病情严重程度,对BP复发具有较高的预测价值。

Objective To analyze the application value of indirect immunofluorescence on salt⁃split skin(IIF⁃SSS)and bullous pemphigoid(BP)180/BP230 antibody assay in evaluating the severity of bullous pemphigoid(BP).Methods 150 BP patients,admitted to Zhengzhou Central Hospital Affiliated to Zhengzhou University from July 2018 to July 2020,were enrolled as research subjects.Data including IIF⁃SSS titre,BP180 and BP230 antibody levels,autoimmune bullous skin disorder intensity score(ABSIS)were collected respectively on visit and on day 30,60,and 180 after visit.The patients were divided into relapse group and non⁃relapse group based on whether BP re⁃occurred within 6 months after the regression of skin lesions.The correlation of IIF⁃SSS titre and BP180/BP230 antibody levels with ABSIS scores and the value in predicting BP relapse were analyzed.Results Among the 150 BP patients,58 cases(38.67%)suffered BP relapse within 6 months after the regression of skin lesions,being set as the relapse group,and the other 92 cases(61.33%)without the BP relapse within 6 months after the regression of skin lesions were set as the non⁃relapse group.On day 30,60,and 180 after visit,the IIF⁃SSS titre,BP180 and BP230 antibody levels,and ABSIS scores of patients in the relapse group were all significantly higher compared with the non⁃relapse group(day 30 after visit:t=4.256,2.828,2.894 and 2.612,P<0.001,P=0.005,P=0.004,P=0.010;day 60 after visit:t=3.959,10.080,5.312 and 3.182,P<0.001,P<0.001,P<0.001,P=0.002;day 180 after visit:t=2.928,12.240,17.020 and 8.575,P=0.004,P<0.001,P<0.001,P<0.001).Pearson correlation analysis showed that IIF⁃SSS titre,BP180 and BP230 antibody levels were all positively correlated with ABSIS scores(r=0.215,0.243 and 0.196,P=0.008,0.003 and 0.016).The receiver operating characteristic(ROC)curve showed that the area under the curve(AUC)of IIF⁃SSS combined with BP180/BP230 antibody assay in predicting BP relapse was 0.826,with the sensitivity being 81.7%and the specificity being 78.8%.Conclusion IIF⁃SSS and BP180/BP230 antibody assay can effectively evaluate the severity of BP and have high value in predicting the recurrence of BP.