【摘要】 背景:抗核抗体、抗着丝点抗体、抗细胞浆抗体、抗拓扑异构酶I抗体是系统性硬皮病疾病形成中产生的几种主要的自身抗体,并与疾病的发展有着密切的关系。目的:通过对系统性硬皮病患者各种自身抗体和蛋白的检测,探讨其在预后评估中的价值。设计:病例-对照实验。单位:江西医学院第二附属医院检验科。对象:选择1995-12/2004-12江西医学院第二附属医院门诊或住院系统性硬皮病患者74例,男19例,女55例,年龄12～59岁,包括皮肤弥漫型系统性硬皮病46例、皮肤局限型系统性硬皮病24例及重叠综合征4例。对照组为同期住院其他疾病患者40例,男14例,女26例,年龄19～54岁。方法:采用间接免疫荧光法检测抗核抗体、抗着丝点抗体、抗细胞浆抗体。采用免疫印迹法检测抗拓扑异构酶I抗体。采用速率散射比浊法检测血清中免疫球蛋白、C-反应蛋白及类风湿因子水平。主要观察指标:①两组患者抗核抗体、抗着丝点抗体、抗拓扑异构酶I抗体、抗细胞浆抗体检测结果。②两组患者血清中免疫球蛋白、C-反应蛋白及类风湿因子水平。结果:74例系统性硬皮病患者,对照组40例的血样合格,全部进入结果分析。①抗核抗体、抗着丝点抗体、抗拓扑异构酶I抗体、抗细胞浆抗体阳性率:系统性硬皮病患者明显高于对照组犤66%(49/74),53%(39/74),39%(29/74),7%(5/74),0,(χ2=57.15,P<0.01)犦。皮肤弥漫型系统性硬皮病患者抗核抗体阳性率明显低于皮肤局限型系统性硬皮病患者犤57%(26/46),83%(20/24),(χ2=5.03,P<0.05)犦、抗拓扑异构酶I抗体阳性率明显高于皮肤局限型系统性硬皮病患者犤48%(22/46),21%(5/24),(χ2=4.85,P<0.05)犦。③系统性硬皮病患者免疫球蛋白G和类风湿因子水平明显高于对照组犤(16.89±11.94),(11.89±2.05)g/L;(23.06±6.18),(22.44±5.53)IU/mL,(t=8.01,2.46,P<0.01)犦。结论:系统性硬皮病患者血清抗核抗体、抗着丝点抗体、抗细胞浆抗体和抗拓扑异构酶I抗体阳性率及免疫球蛋白G和类风湿因子水平明显增高,以上实验室指标的检测对预后评估有重要意义。更多还原

【Abstract】 BACKGROUND: Antinuclear antibody, anticentromere antibody, anti-cytoplasm antibody, and antibody against SCL-70 are the main self-antibodies involved in systemic scleroderma (SSc) and are closely connected with the development of SSc. OBJECTIVE: To probe the value of various self-antibodies and proteins in evaluating the functional prognosis of patients with SSc. DESIGN: Case-control study. SETTING: Clinical Laboratory of Second Hospital Affiliated to Jiangxi Medical College. PARTICIPANTS: Totally 74 patients, 19 males and 55 females aged 12-59 years old, were confirmed of SSc at the outpatient and inpatient departments of Second Hospital Affiliated to Jiangxi Medical College between December 1995 and December 2004. There were 46 cases of diffuse cutaneous SSc, 24 cases of localized cutaneous SSc, and 4 cases of overlapping syndrome. Meanwhile 40 inpatients (14 males and 26 females aged 19-54 years old) who received treatment due to other diseases were recruited from the same hospital. METHODS: The level of antinuclear antibody, anticentromere antibody, and anti-cytoplasm antibody was detected with indirect immuneofluorescence assay; antibody against SCL-70 was detected with Western blot; the level of serum immunoglobulin, C-reactive protein (CRP) and rheumatoid factor was examined with velocity dispersion turbidimetry. MAIN OUTCOME MEASURES: ① The level of antinuclear antibody, anticentromere antibody, anti-cytoplasm antibody, and antibody against SCL-70; ② the level of serum immunoglobulin, CRP and rheumatoid factor; RESULTS: Blood samples collected from the 74 patients with SSc and 40 controls were proved eligible and all data entered the final statistical analysis. ① The positive rate of antinuclear antibody, anticentromere antibody, anti-cytoplasm antibody, and antibody against SCL-70: It was obviously higher in SSc group than in control group [66% (49/74), 53% (39/74), 39% (29/74), 7% (5/74), 0, (χ2=57.15, P < 0.01)]. The positive rate of antinuclear antibody in patients with diffuse cutaneous SSc was significantly lower than in patients with localized cutaneous SSc [57% (26/46), 83% (20/24),(χ2=5.03, P < 0.05)], but the positive rate of antibody against SCL-70 was significantly higher than localized cutaneous SSc [48% (22/46), 21% (5/24), (χ2=4.85, P < 0.05)]. ② The level of immunoglobulin G and rheumatoid factor in patients with SSc was markedly higher than in control group [(16.89±11.94), (11.89±2.05) g/L; (23.06±6.18), (22.44±5.53) IU/mL, t=8.01, 2.46, P < 0.01]. CONCLUSION: The positive rate of antinuclear antibody, anticentromere antibody, anti-cytoplasm antibody, and antibody against SCL-70, as well as the level of immunoglobulin G and rheumatoid factor were obviously increased in patients with SSc, suggesting that these experimental parameters have the value in evaluating the prognosis of SSc.更多还原