本文選題：原發(fā)性干燥綜合征 + 抗SP1抗體��； 參考：《福建中醫(yī)藥大學(xué)》2015年碩士論文

【摘要】：目的：Salivary gland protein 1(SP1)蛋白是干燥綜合征(SS)患者涎腺中新發(fā)現(xiàn)的自身抗原。本研究為國內(nèi)首次通過免疫印跡法檢測漢族原發(fā)性干燥綜合征(pSS)血清中抗SP1抗體表達(dá)水平,探索該抗體在該疾病診斷及早期診斷的意義,并分析其與疾病活動(dòng)度、各臟器受累和實(shí)驗(yàn)室指標(biāo)的關(guān)系。方法：連續(xù)收集119例廈門大學(xué)附屬第一醫(yī)院風(fēng)濕免疫科及眼科確診為pSS漢族患者和50例無SS的類風(fēng)濕關(guān)節(jié)炎(RA)患者,并招募50名健康為健康對照組。其中pSS分為：A組(SSA- and SSB-:n=23);B組(SSA+ or SSB+:n=49);C組(SSA+ and SSB+: n=47)。運(yùn)用免疫印跡法(Westernblot)檢測各組抗SP1抗體的表達(dá)情況,并分析其與pSS患者疾病活動(dòng)度、唇腺組織活檢病理分級、臟器受累及免疫學(xué)指標(biāo)、炎癥指標(biāo)的關(guān)系。結(jié)果：1、免疫印跡法檢測各組中抗SP1抗體：在119例漢族pSS患者的陽性率為39.5%,顯著高于RA組22%(P=0.029)及健康對照組10%(***P0.0001),且其特異性為84%,但明顯高于抗ANA抗體。2、抗SP1抗體與SSA、SSB兩兩聯(lián)合檢測或3種抗體聯(lián)合檢測互為補(bǔ)充,明顯高于單一抗體的陽性率,其中以3種抗體聯(lián)合檢測陽性率最高,達(dá)88.2%。3、pSS各亞組的陽性率情況：A組(SSA- and SSB-:n=23):39.1%:B組(SSA+ or SSB+: n=49):55%;C組SSA、SSB均陽性組(SSA+ and SSB+:n=47):23%,且A組與健康對照組具有明顯統(tǒng)計(jì)學(xué)差異(***P=0.001)。4、抗SP1抗體陽性組(n=47)與SP1陰性組(n=72)的ESSDAI無明顯差異,但抗SP1抗體陽性的患者明顯集中分布在ESSDAI≤2中。5、發(fā)現(xiàn)抗SP1抗體陽性的pSS患者組平均病程為2.5(±1.7)年,明顯短于抗體陰性的患者組平均病程為3.68(±2.8)年,具有統(tǒng)計(jì)學(xué)差異(*P=0.044),且陽性組唇腺組織Chisholm等級均較低,以A組最為明顯,均≤Ⅲ級。6、抗體陽性患者的淋巴組織及腺體組織受累較抗體陰性組明顯增高,具有統(tǒng)計(jì)學(xué)差異(*P=0.02),但與免疫球蛋白(IgG)、補(bǔ)體(C3)、類風(fēng)濕因子(RF)、抗抗環(huán)瓜氨酸抗體(CCP)、C反應(yīng)蛋白(CRP)等指標(biāo)無明顯統(tǒng)計(jì)學(xué)差異。結(jié)論：本研究為首次檢測漢族pSS患者抗SP1抗體的表達(dá)情況,結(jié)果表明抗SP1抗體是pSS較特異性的自身抗體之一,聯(lián)合抗SSA、SSB抗體有助于提高pSS的診斷,且能提高該病早期診斷,并參與了pSS患者的唾液腺組織損傷及免疫病理改變,但其具體作用機(jī)制需要進(jìn)一步研究明確。
[Abstract]:Objective\%\ This study was the first time in China to detect the expression level of anti SP1 antibody in serum of Han nationality with primary Sjogren's syndrome (PSS) by Western blotting, to explore the significance of anti SP1 antibody in the diagnosis and early diagnosis of the disease, and to analyze its association with disease activity. The relationship between the involvement of various organs and laboratory indexes. Methods: one hundred and nineteen patients with pSS and 50 patients with rheumatoid arthritis (RA) without SS were collected from Department of Rheumatological Immunology and Ophthalmology of the first affiliated Hospital of Xiamen University and 50 healthy subjects were recruited as healthy control group. PSS was divided into two groups: SSA- and SSB-W: SSA-SSB-B group (SSA) or SSB group SSA-SSB-B, group C (SSA-SSB-7), group C (SSA-SSB-7) and group C (SSA-SSB-7). Western blotting was used to detect the expression of anti SP1 antibody in each group, and the relationship between the expression of anti SP1 antibody and disease activity, pathological grade of labial gland biopsy, organ involvement, immunological index and inflammation index in pSS patients was analyzed. Results: the positive rate of anti SP1 antibody in 119 pSS patients of Han nationality was 39.5, which was significantly higher than that in RA group and healthy control group. The specificity was 84g, but significantly higher than that of anti ANA antibody, anti SP1 antibody and SSASSB antibody. The two combined tests or the combined detection of three kinds of antibodies are complementary to each other. The positive rate of single antibody was significantly higher than that of single antibody, among which the positive rate of three kinds of antibody combined detection was the highest. The positive rate of SSA-SSA-SSA-SSA-SSA-SSA-SSA-SSA-SSA-SSA-SSA-SSA or SSB: nd49.555in group C was not significantly different from that in group A and control group (P 0.001. 4). There was no significant difference in ESSDAI between group A and group A (P 0.001. 4) and SP1 negative group (P < 0. 001. 4), but there was no significant difference between group A and control group (P 0. 001. 4). However, the mean course of the patients with anti SP1 antibody positive was 2.5 (鹵1.7) years, and the average course of disease was 3.68 (鹵2.8) years in the patients with anti SP1 antibody positive than that in the negative patients, and the mean course of the patients with anti SP1 antibody positive was 3. 68 (鹵2. 8) years, while that of the patients with anti SP1 antibody positive was 3. 68 (鹵2. 8) years. The Chisholm grade of labial gland in the positive group was lower than that in the negative group, especially in group A (鈮，

本文編號：1911667