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中国临床研究:2022,35(6):747-754
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肌炎抗体谱与特发性炎性肌病的临床分析
(海南医学院第二附属医院风湿免疫科,海南 海口 571100)
Myositis autoantibody profiles and idiopathic inflammatory myopathies
(Department of Rheumatology and Immunology, The Second Affiliated Hospital ofHainan Medical University, Haikou, Hainan 571100, China)
摘要
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投稿时间:2021-10-15   网络发布日期:2022-06-20
中文摘要: 目的 分析海南地区特发性炎性肌病(IIMs)患者肌炎特异性抗体(MSAs)和肌炎相关性抗体(MAAs)的阳性率及临床相关性。方法 收集2018年1月至2021年3月在海南医学院第二附属医院风湿免疫科住院确诊IIMs患者78例病例资料进行回顾性分析。通过免疫印迹法检测患者的MSAs和MAAs的阳性率,分析其与临床资料的相关性。结果 根据最新EULAR/ACR分类标准,本队列中33.3%的患者被确定为可疑IIMs。多发性肌炎(PM)是最常见的临床亚型。MSA的阳性率为82.1%,其中以抗Jo-1抗体、抗SRP抗体最常见,阳性率分别为41.0%、25.6%。在IIMs的4个临床亚型中,仅有抗MDA5抗体在无肌病性皮肌炎(ADM)阳性率明显升高,抗MDA5抗体阳性患者肺部损害严重,尤其以快速进展性的肺疾病为主,并与皮肌炎(DM)经典皮疹呈相关性。抗合成酶抗体(ASAs)与关节炎、间质性肺疾病(ILD)呈相关性。抗SRP抗体阳性率为25.6%,90.0%患者出现在PM,与血清CK、LDH、吞咽困难呈相关性。抗NXP2抗体、抗TIF1-γ抗体阳性率低,其中1例抗TIF1-γ抗体患者病理诊断为胆管癌。MAAs阳性率为61.5%,最常见的MAAs是抗RO-52抗体(56.4%),并与关节炎、技工手呈相关性。抗Ro-52抗体与抗Jo-1抗体显著相关。结论 大多数IIMs患者存在MSAs和MAAs阳性,并与临床亚型、临床特征存在一定相关性。因此,MSAs可能在IIMs诊断、治疗及预后的评估中具有重要作用。
Abstract:Objective To analyze the prevalence of myositis specific autoantibodies (MSAs) and myositis associated autoantibodies (MAAs) and their clinical correlations in the patients with idiopathic inflammatory myopathies (IIMs) in Hainan. Methods A total of 78 IIMs inpatients confirmed in the Second Affiliated Hospital of Hainan Medical University from January 2018 to March 2021 were selected. By immunoblotting, the prevalence of MSAs and MAAs were detected to analyze their correlations with clinical data in all patients. Results According to the latest EULAR/ACR classification criteria, 33% of patients in this cohort were identified as suspicious IIMS. Polymyositis (PM) was the most common clinical subtype of IIMs. MSAs was found in 82.1% of patients. The most frequently detected autoantibodies were anti-Jo-1(41.0%) and anti-SRP (25.6%). Among the four clinical subgroups of IIMs, anti-MDA5 positivity was significantly associated with amyopathic dermatomyositis (ADM), which presented severe lung damage, especially in rapidly progressive pulmonary disease and was correlated with classic dermatomyositis (DM) rash. The anti-synthetase antibodies (ASAs) was correlated with arthritis and interstitial lung disease (ILD). The anti-signal recognition particle (anti-SRP) positive rate (25.6%) was 90.0% of PM patients, and was related with serum creatine kinase (CK), lactate dehydrogenase (LDH) and dysphagia. The positivities of anti-nuclear matrix protein 2 (NXP2) and anti-transcription intermediary factor 1 (TIF1-γ) were low, appearing in 1 case of pathologically diagnosed as cholangiocarcinoma. The positive anti-Ro-52 (56.4%) in the most common detected MAAs (61.5%) was associated with arthritis and mechanic’s hands. Anti-Ro-52 was significantly correlated with anti-Jo-1. Conclusion MSAs and MAAs appear in the majority of IIMs patients and are related to clinical subtypes and clinical charactereristics. Therefore, MSAs may play an important role in the diagnosis, treatment and prognosis of IIMs.
文章编号:     中图分类号:R685    文献标志码:A
基金项目:海南医学院第二附属医院科研培育基金(2018-19)
引用文本:
姚奇岑,邢诒喜,林千祺,梁金,黄美琼,许夏雨,陈艺玲,陈玉雅,陈维飞.肌炎抗体谱与特发性炎性肌病的临床分析[J].中国临床研究,2022,35(6):747-754.

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