免疫球蛋白G型抗环瓜氨酸肽抗体在原发性干燥综合征患者血清中的检出率及其意义

摘要/Abstract

摘要： 目的：探讨免疫球蛋白G(immunoglobulin G, IgG) 型抗环瓜氨酸肽 (cyclic citrullinated peptides, CCP) 抗体在原发性干燥综合征(primary Sjögren’s syndrome，PSS) 患者中的检出率及其在PSS中的意义。方法：选取2006年3月至2009年12月在包头医学院第一附属医院确诊的PSS患者120例，用酶联免疫吸附试验 (enzyme-linked immunosorbent assay, ELISA) 定量测定患者血清中的IgG型抗CCP抗体，免疫印迹法检测抗干燥综合征A（Sjögren’s syndrome type A，SSA）抗体和抗干燥综合征B（Sjögren’s syndrome type B，SSB）抗体，魏氏法检测红细胞沉降率(erythrocyte sedimentation rate, ESR)，免疫比浊法检测C反应蛋白 (C reactive protein, CRP)、免疫球蛋白A (immunoglobulin A, IgA)、IgM、IgG和IgM型类风湿因子 (rheumatoid factor, RF) 的水平，同时观察患者临床症状和重要脏器受累情况；对上述患者定期随访3年，观察其进展为类风湿关节炎（rheumatoid arthritis, RA）的情况。结果: (1) 抗CCP抗体在PSS患者中的检出率为19.17%；(2) 随访3年，抗CCP抗体阳性患者比阴性患者更容易进展为RA (χ²=5.015，P=0.022)；(3) 抗CCP抗体阳性患者比阴性患者更容易出现关节受累(χ²=8.058，P<0.05)，肿胀关节更多(U=152.00，P<0.05)，晨僵持续时间更长(U=100.00，P<0.05)，但两组患者重要脏器受累的比例相当(χ²分别为0.208、0.099、0.000、0.122，P>0.05)；(4) 抗CCP抗体阳性患者与阴性患者比较，抗SSA、SSB抗体的阳性率无明显差别（χ²分别为0.008、0.560，P>0.05）；(5)多重线性回归显示，PSS患者抗CCP抗体的水平与IgM 型RF水平呈正相关(B=0.61, 95%CI=0.36~0.86, P<0.05)，而与ESR、CRP、IgA、IgM及 IgG等水平无明显的相关性（P>0.05）；(6)抗CCP抗体阳性患者与阴性患者比较，ESR、CRP、IgA、IgM及 IgG水平的差异无统计学意义（P>0.05），但抗CCP抗体阳性组IgM 型RF水平明显高于阴性组(U=623.50, P<0.05)。结论： IgG型抗CCP抗体在PSS中的阳性率为19.17%，与PSS患者关节受累相关，且抗CCP抗体阳性的患者更容易进展为RA。

关键词: 干燥综合征, 环瓜氨酸肽, 自身抗体, 生物学标记, 血清

Abstract: Objective：To investigate the prevalence and significance of IgG-anti-cyclic citrullinated peptides (CCP) antibody in PSS patients. Methods: A total of 120 patients diagnosed with PSS were investigated in the first affiliated hospital of Baotou Medical College from March 2006 to December 2009. IgG-anti-CCP antibody was assayed by enzyme-linked immunosorbent assay (ELISA), also anti-Sjögren’s syndrome type A (SSA) and Sjögren’s syndrome type B (SSB) antibody were assayed by immunoblotting. Erythrocyte sedimentation rate (ESR) was assayed by westergren in serum, and C reactive protein (CRP), IgA, IgM, IgG and IgM-RF were detected by immune turbidimetric. At the same time, clinical symptoms and involvement of important organs were observed. Following up the patients above 3 years, the primary Sjögren’s syndrome (PSS) patients who had progressed to rheumatoid arthritis (RA) were evaluated. Results: The positive rate of anti-CCP antibody in the PSS patients was 19.17%; After 3 years, more patients who were positive for anti-CCP antibody had progressed to RA (χ²=5.015，P=0.022) than the patients in negative group; The patients in anti-CCP antibody positive group were more prone to joint involvement (χ²=8.058，P<0.05), more swollen joints (U=152.00，P<0.05) and longer morning stiffness (U=100.00，P<0.05) than the patients with negative anti-CCP antibody, but the involvement of vital organs in the two groups had no significant difference (χ²=0.208，0.099，0.000 and 0.122，P>0.05); The positive rate of anti-SSA and SSB antibody in anti-CCP antibody positive group and negative group had no significant difference (χ²=0.008 and 0.56，P>0.05); Multiple linear regression showed that the level of anti-CCP antibody was positively correlated with IgMRF levels in the PSS patients (B=0.61, 95%CI=0.36-0.86, P<0.05), but had no significant correlation with ESR, CRP, IgA, IgM and IgG levels (P>0.05).There were no significant differences in the level of ESR, CRP, IgA, IgM and IgG between anti-CCP antibody positive group and negative group (P>0.05), but the level of IgM-RF in anti-CCP antibody positive group was significantly higher than that in the negative group (U=623.50, P<0.05).Conclusion: Positive rate of IgG-anti-CCP antibody in PSS is 19.17%, also it is associated with joint involvement and more prone to progressing to RA.

Key words: Sjögren’s syndrome, Cyclic citrullinated peptide, Autoantibodies, Biological markers, Serum

刘媛, 王永福, 王凯丽, 吕凤凤. 免疫球蛋白G型抗环瓜氨酸肽抗体在原发性干燥综合征患者血清中的检出率及其意义[J]. 北京大学学报（医学版）, 2014, 46(3): 478-482.

LIU Yuan, WANG Yong-Fu, WANG Kai-Li, 吕Feng-Feng . Prevalence and significance of immunoglobulin G-anti-cyclic citrullinated peptide antibodies in primary Sjögren’s syndrome patients[J]. Journal of Peking University(Health Sciences), 2014, 46(3): 478-482.

参考文献

相关文章 15

[1]	肖云抒,朱冯赟智,罗澜,邢晓燕,李玉慧,张学武,沈丹华. 88例重叠肌炎的临床及免疫学特征[J]. 北京大学学报（医学版）, 2021, 53(6): 1088-1093.
[2]	罗澜,邢晓燕,肖云抒,陈珂彦,朱冯赟智,张学武,李玉慧. 抗合成酶综合征合并心脏受累患者的临床及免疫学特征[J]. 北京大学学报（医学版）, 2021, 53(6): 1078-1082.
[3]	杨群智,张舸,费雅楠,付爽,闫冰. 沙利度胺治疗原发性干燥综合征合并轻中度非特异性间质性肺炎疗效观察[J]. 北京大学学报（医学版）, 2021, 53(2): 413-416.
[4]	俞光岩. 多发性唾液腺肿大的鉴别诊断及处理[J]. 北京大学学报（医学版）, 2021, 53(1): 1-4.
[5]	池彦廷,张延平,张秋露,刘翠苓,李斌斌. 唾液腺干燥综合征继发黏膜相关淋巴组织淋巴瘤的临床病理分析[J]. 北京大学学报（医学版）, 2021, 53(1): 40-45.
[6]	郑艺明,郝洪军,刘怡琳,郭晶,赵亚雯,张巍,袁云. Ro52抗体与其他肌炎抗体共阳性的相关性研究[J]. 北京大学学报（医学版）, 2020, 52(6): 1088-1092.
[7]	赵静,孙峰,李云,赵晓珍,徐丹,李英妮,李玉慧,孙晓麟. 抗α-1C微管蛋白抗体在系统性硬化症中的表达及临床意义[J]. 北京大学学报（医学版）, 2020, 52(6): 1009-1013.
[8]	张警丰,叶修玲,段萌,周小利,姚中强,赵金霞. 抗核抗体阳性类风湿关节炎的临床和实验室检查特点[J]. 北京大学学报（医学版）, 2020, 52(6): 1023-1028.
[9]	王一帆,范稹,成姚斌,金月波,霍阳,何菁. 原发性干燥综合征患者睡眠障碍的相关影响因素[J]. 北京大学学报（医学版）, 2020, 52(6): 1063-1068.
[10]	朱冯赟智,邢晓燕,汤晓菲,李依敏,邵苗,张学武,李玉慧,孙晓麟,何菁. 肌炎合并血栓栓塞患者的临床及免疫学特征[J]. 北京大学学报（医学版）, 2020, 52(6): 995-1000.
[11]	陈伟钱,戴小娜,余叶,王沁,梁钧昱,柯旖旎,易彩虹,林进. 原发性干燥综合征合并自身免疫性肝病的临床特点及预后分析[J]. 北京大学学报（医学版）, 2020, 52(5): 886-891.
[12]	李英妮,相晓红,赵静,李云,孙峰,王红彦,贾汝琳,胡凡磊. 抗类瓜氨酸化抗体在系统性红斑狼疮中的意义[J]. 北京大学学报（医学版）, 2019, 51(6): 1019-1024.
[13]	宁晓然,王子乔,张珊珊,张霞,唐素玫,刘燕鹰. 超声评分系统在IgG4相关涎腺炎评估中的应用[J]. 北京大学学报（医学版）, 2019, 51(6): 1032-1035.
[14]	王嘉禹,赵美萍. 荧光分析法测定人体血液样品中脱嘌呤/脱嘧啶核酸内切酶1(APE1)的活性[J]. 北京大学学报（医学版）, 2019, 51(3): 487-492.
[15]	杨伊莹,左晓霞,朱红林,刘思佳. 皮肌炎/多肌炎表观遗传学标志物的研究进展[J]. 北京大学学报（医学版）, 2019, 51(2): 374-377.

Metrics

Viewed

Full text

Abstract

Cited

Shared

Discussed