【摘要】 目的:观察干燥综合征患者(SS)血清抗α-胞衬蛋白、干扰素-γ(IFN-γ)、肿瘤坏死因子-α(TNF-α)水平及抗SSA/SSB抗体与患者唇腺活检病理损害的关系,探讨SS患者的抗体表达、免疫异常与唇腺病理损害的相关性。方法:收集SS患者36例为SS组。具有口干症状、慢性非唇腺、唾液腺免疫性炎症的非干燥综合征患者24例为非SS组,两组均行唇腺活检。同时记录患者的一般资料及临床数据,包括年龄、性别、病程、临床体征,记录口干评分,血清学指标包括类风湿因子(RF)、C-反应蛋白(CRP)、血细胞沉降率(ESR),抗SSA/SSB抗体、血清干扰素水平等。结果:①与非SS组比较,SS组唇腺活检阳性率达100%,显著高于非SS组(P<0.05);两组的年龄和性别比较差异无统计学意义(均P>0.05)。②与非SS组比较,SS组的CRP及ESR水平明显增高(P<0.05),抗α-胞衬蛋白、抗SSA/SSB抗体、抗CCP抗体、RF阳性率也高于非SS组。③与轻度病理损伤组比较,中重度病理损伤组抗α-胞衬蛋白的比率无统计学差异;与轻度病理损伤组比较,中重度病理损伤组抗SSB抗体阳性率均明显升高,两组比较差异具有统计学意义,而抗SSA抗体两组间比较无统计学差异(P>0.05)。③TNF-α与每低倍视野下导管扩张数、腺泡萎缩数具有相关性(P<0.05),而CRP、ESR与其未见相关性(P>0.05);TNF-α、CRP和ESR与唇腺灶性指数、淋巴细胞计数均具有相关性(P<0.05);IFN-γ与淋巴细胞计数具有相关性(P<0.05),而与导管扩张数、腺泡萎缩数未见明显相关性(P<0.05)。结论:SS的发病与免疫异常密切相关,SS的唇腺淋巴细胞浸润、腺泡损害等病理损害,可能由于多种自身抗体、细胞因子的作用调控而发生发展的。更多还原

【Abstract】 Objective:To observe the relationship between anti-α-lining protein,interferon-γ(IFN-γ),tumor necrosis factor-α(TNF-α),anti-SSA/SSB antibodies and pathological damage of the labial glands in patients with Sjogren’s syndrome(SS),and explore the correlation between antibody expression,immune abnormality and pathological damage of labial glands in SS patients.Methods:36 confirmed SS patients were collected as the SS group.24 patients with non-Sjogren’s syndrome with xerostomia,chronic non-labial and salivary gland immune inflammation were collected as the non-SS group.Both groups underwent labial biopsy.At the same time,the general information and clinical data of patients were recorded,including age,gender,course of disease,clinical signs,dry mouth scores,serological indicators[rheumatoid factor(RF),C-reactive protein(CRP),blood cell sedimentation rate(ESR),AntiSSA/SSB antibodies,serum interferon levels,etc].Results:The positive rate of lip gland biopsy in SS group was 100%,which was significantly higher than that in non-SS group(P<0.05).There was no significant difference in age and sex between the two groups(all P>0.05).Compared with non-SS group,CRP and ESR levels in SS group were significantly higher(P<0.05),and the positive rates of anti-a-cell lining protein,anti-SSA/SSB antibody,anti-CCP antibody and RF were also higher.Compared with mild pathological injury group,the ratio of anti-α-cell lining protein in moderate and severe pathological injury group had no significant difference.Compared with mild pathological injury group,the positive rates of anti-SSB antibody in moderate and severe pathological injury group significantly increased,and the difference between the two groups was statistically significant,while there was no statistical difference in anti-SSA antibody between the two groups.TNF-α had a correlation with the number of catheter dilatations and acinar atrophy per macrovision(P<0.05),but CRP and ESR have no correlation with it(P>0.05).TNF-α,CRP and ESR were correlated with focal index of labial gland and lymphocyte count(P<0.05).IFN-γ was correlated with lymphocyte count(P<0.05),but not with catheter dilatations and acinar atrophy.Conclusion:The pathogenesis of SS is closely related to immune abnormalities.The pathological changes such as infiltration of labial gland lymphocytes and acinar lesion of SS may occur and promote the development due to the regulation of various autoantibodies and cytokines.更多还原