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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。
BACKGROUND: Antinuclear antibodies, anti-centromere antibodies, anti-cytoplasmic antibodies, anti-topoisomerase I antibodies are several of the major autoantibodies produced in the development of systemic scleroderma and are closely related to the development of the disease relationship. OBJECTIVE: To investigate the value of various autoantibodies and proteins in patients with systemic scleroderma through the evaluation of prognosis. Design: Case-control experiment. Unit: Second Affiliated Hospital of Jiangxi Medical College Laboratory. PARTICIPANTS: A total of 74 patients with systemic scleroderma in the Second Affiliated Hospital of Jiangxi Medical College from December 1995 to December 2004 were selected, including 19 males and 55 females aged 12-59 years old, including systemic diffuse hard 46 cases of dermatosis, 24 cases of systemic localized scleroderma and 4 cases of overlap syndrome. Control group for the same period hospitalized patients with other diseases 40 cases, 14 males and 26 females, aged 19 to 54 years. Methods: Indirect immunofluorescence assay was used to detect anti-nuclear antibody, anti-centromere antibody and anti-cytoplasmic antibody. Anti-topoisomerase I antibody was detected by Western blotting. Serum immunoglobulin, C-reactive protein and rheumatoid factor levels were measured by rate nephelometry. MAIN OUTCOME MEASURES: ①Two groups of patients anti-nuclear antibody, anti-centromere antibody, anti-topoisomerase I antibody, anti-cytoplasmic antibody test results. ② serum immunoglobulin, C-reactive protein and rheumatoid factor levels in both groups. Results: The blood samples from 74 patients with systemic scleroderma and control group were all qualified and all were included in the result analysis. ① The positive rates of anti-nuclear antibody, anti-centromere antibody, anti-topoisomerase I antibody and anti-cytoplasm antibody were significantly higher in patients with systemic scleroderma than those in control group (66/49), 53% (39) /74),39%(29/74),7%(5/74),0,(χ2=57.15,P<0.01) 犦. The positive rate of antinuclear antibodies in patients with diffuse systemic scleroderma was significantly lower than that in patients with systemic scleroderma (57% (26/46), 83% (20/24), χ2 = 5.03, P < (Χ2 = 4.85, P <0.05), the positive rate of anti-topoisomerase I antibody was significantly higher in patients with systemic scleroderma than in patients with systemic scleroderma (48% (22/46), 21% ) 犦. The levels of immunoglobulin G and rheumatoid factor in patients with systemic scleroderma were significantly higher than those in control group (16.89 ± 11.94, 11.89 ± 2.05g / L, (23.06 ± 6.18), (22.44 ± 5.53) IU / mL, (t = 8.01,2.46, P <0.01) 犦. Conclusion: The positive rates of serum anti-nuclear antibody, anti-centromere antibody, anti-cytoplasmic antibody and anti-topoisomerase I antibody in patients with systemic scleroderma and the levels of immunoglobulin G and rheumatoid factor were significantly increased. The above laboratory indexes The detection of prognostic evaluation of great significance.