分析HLA-DQA1基因与干燥综合征患者临床特征的相关性

Analyzing the correlation between HLA-DQA1 gene and clinical characteristics of patients with Sjögren's syndrome

目的 探讨人类白细胞抗原DQA1(human leucocyte antigen-DQA1,HLA-DQA1)与干燥综合征(Sjögren’s syndrome,SS)患者临床特征的相关性。方法 选取2022年8月至2023年8月包头医学院第一附属医院收治的242例SS患者为研究对象,根据HLA-DQA1检测结果,将患者分为HLA-DQA1阳性组(n=147)和HLA-DQA1阴性组(n=95)。比较两组患者的临床表现、实验室指标、唇腺活检和疾病活动度。采用受试者操作特征曲线分析HLA-DQA1对SS患者疾病活动度的诊断价值。结果 HLA-DQA1阳性组患者的口干、眼干、紫癜占比和抗干燥综合征A抗体(anti-Sjögren’s syndrome A antibody,抗SSA抗体)、抗干燥综合征B抗体(anti-Sjögren syndrome’s B antibody,抗SSB抗体)、抗核抗体(antinuclearantibody,ANA)阳性占比及免疫球蛋白G水平均显著高于HLA-DQA1阴性组(P<0.05),血红蛋白水平显著低于HLA-DQA1阴性组(P<0.05);HLA-DQA1阳性组患者的疾病活动度显著高于HLA-DQA1阴性组(P<0.05)。HLA-DQA1、抗SSA抗体、抗SSB抗体判断SS患者疾病活动度的曲线下面积分别为0.593、0.534、0.593。三者联合判断SS患者疾病活动度的曲线下面积为0.638。结论 HLA-DQA1与SS患者的疾病活动度相关,在HLA-DQA1阳性患者中,口干、眼干、高球蛋白血症、贫血和紫癜等症状更明显,同时,抗SSA/SSB抗体和ANA阳性率较高,提示HLA-DQA1表达有助于判断SS患者的病情。

Objective To investigate the correlation between human leucocyte antigen-DQA1(HLA-DQA1) and clinical characteristics of patients with Sjögren's syndrome(SS).Methods A total of 242 SS patients admitted to the First Affiliated Hospital of Baotou Medical College from August 2022 to August 2023 were selected as the study objects.According to the HLA-DQA1 test results,the patients were divided into HLA-DQA1 positive group(n=147) and HLA-DQA1 negative group(n=95).The clinical manifestations,laboratory indicators,labial gland biopsy and disease activity were compared between two groups.Receiver operating characteristic curve was used to analyze the diagnostic value of HLA-DQA1 for disease activity in SS patients.Results The proportion of dry mouth,dry eye and purpura,the proportion of anti-SSA antibodies,anti-SSB antibodies,antinuclear antibody(ANA) positive and the level of immunoglobulin G in HLA-DQA1 positive group were significantly higher than those in HLA-DQA1 negative group(P<0.05),and the hemoglobin level was significantly lower than that in HLA-DQA1negative group(P<0.05).The disease activity of HLA-DQA1 positive group was significantly higher than that of HLA-DQA1negative group(P<0.05).The areas under the curve of HLA-DQA1,anti-SSA antibody and anti-SSB antibody to determine the disease activity of SS patients were 0.593,0.534 and 0.593,respectively.The area under the curve of disease activity of SS patients judged by the three indexes combined was 0.638.Conclusion HLA-DQA1 is correlated with the disease activity of SS patients.In HLA-DQA1 positive patients,dry mouth,dry eyes,hyperglobulinemia,anemia and purpura were more obvious.Meanwhile,the positive rates of anti-SSA/SSB antibodies and ANA were higher,suggesting that HLA-DQA1 expression is helpful in judging the disease of SS patients.