目的通过检测SSA抗体、SSB抗体、M3受体蛋白多肽(M3RP)抗体、α-胞衬蛋白IgG抗体在原发性干燥综合征(pSS)的敏感性与特异性,分析4种抗体在pSS诊断中的应用价值。方法选pSS患者110例,类风湿关节炎(RA)患者80例,系统性红斑狼疮(SLE)患者80例,用斑点法检测所有患者的SSA抗体、SSB抗体,ELISA法检测所有患者的M3RP抗体、α-胞衬蛋白IgG抗体。结果M3RP抗体、α-胞衬蛋白IgG抗体、SSA抗体、SSB抗体在pSS患者中的敏感性分别为78.2%、77.3%、45.5%、30.9%,均高于RA(6.2%、10.0%、6.2%、0)和SLE患者(9.9%、11.3%、28.8%、5.0%)(P值均小于0.05)。SSA抗体、SSB抗体、M3RP抗体、α-胞衬蛋白IgG抗体在pSS患者中的特异性分别为83.8%、97.7%、92.0%、90.0%。M3RP抗体、α-胞衬蛋白抗体在SSA抗体和(或)SSB抗体阴性的pSS患者中的阳性率分别为66.1%、69.5%。SSA抗体或SSB抗体联合M3RP抗体或α-胞衬蛋白抗体,可使pSS诊断的敏感性提高至88.2%,α-胞衬蛋白抗体、M3RP抗体联合检测时敏感性达83.6%。2种抗体联合检测与3种抗体联合检测比较,其对诊断的敏感性、特异性无统计学意义。结论SSA抗体或SSB抗体联合M3RP抗体和(或)α-胞衬蛋白抗体检测,可明显提高pSS诊断的敏感性。SSB抗体、M3RP抗体、α-胞衬蛋白IgG抗体在pSS诊断中均有较高的特异性。
Objective To compare the specificity and sensitivity of antibodies against SSA and SSB, anti-M3 receptor polypeptide antibodies, anti-α-fodrin (IgG)antibodies in primary Sjogren's syndrome (pSS). Methods One hundred and ten pSS patients (mean age was 49.2 ± 14. 8, mean disease duration was 5. 6 ± 4.6), 80 systemic lupus erythmatosis ( SLE ) patients ( mean age was 25. 5 ± 4. 6, mean disease duration was 2. 5 ± 1.2) and 80 rheumatoid arthritis(RA) patients(mean age was 44. 6 ±3.5,mean disease duration was 4. 2 ± 1.1 ) were studied. Enzyme-hnked immunosorbent assay was used to measure these antibodies. Results The seropositive rates of anti-SSA, anti-SSB antibodies, anti-M3 receptor polypeptide antibodies and anti-α-fodrin (IgG) antibodies were 45. 5%, 30. 9%, 78.2% and 77. 3%, respectively in pSS. They were much higher than those in RA and SLE patients ( P 〈 0. 05 ). Specificities of SSA, SSB antibodies,anti-M3 receptor antibodies and anti-α-fodrin IgG were 83. 8% ,97.7% ,92.0% and 90. 0% respectively. With the combination of these antibodies in the diagnosis of pSS, the sensitivity can be increased at least to 88.2% and the specificity was not decreased significantly. Conclusion Combination of these antibodies can significantly improve the sensitivity of these antibodies in the diagnosis of pSS. Anti-SSA and SSB antibodies, anti-M3 receptor antibodies and anti-α-fodrin(IgG) antibodies are specific antibodies for the diagnosis of pSS.