摘要
Abstract
Objective:To analyze the differences of clinical manifestations and laboratory features be-tween primary Sjögren's syndrome(pSS)patients with positive and negative anti-Sjögren's syndrome type B(SSB)antibody.Methods:The clinical data of pSS patients hospitalized in Department of Rheumato-logy and Immunology,Peking University Third Hospital were retrospectively analyzed to investigate the differences of clinical and laboratory features between anti-SSB positive and negative groups.The t test,Mann-Whitney U test,Chi-square test and Fisher's exact probability were used for analysis.Results:A total of 142 pSS patients were enrolled in this study,including 137 females and 5 males with a mean age of(54.8±13.3)years.The anti-SSB positive group included 44 patients accounting for 31.0％of the pSS patients.The anti-SSB positive pSS patients were younger at disease onset and at visit[age at visit:(50.9±14.5)years vs.(56.5±12.4)years;age at onset:(42.2±14.8)years vs.(49.5±15.3)years,P＜0.05].The patients with anti-SSB positive more frequently presented with rash(29.5％vs.14.3％,P＜0.05),enlargement of parotid glands(27.3％vs.8.2％,P＜0.05),renal tubular acido-sis(15.9％vs.4.2％,P＜0.05),immune thrombocytopenia(9.1％vs.1.0％,P＜0.05),rheuma-toid factor(RF)positive(85.0％vs.49.4％,P＜0.05),higher RF and antinuclear antibody(ANA)titers(median:89.8 IU/mLvs.20.5 IU/mL;median:320 vs.160,P＜0.05),anti-Sjögren's syn-drome type A(SSA)antibody positive(97.7％vs.64.3％,P＜0.05),elevation of γ globulin(71.4％vs.38.5％,P＜0.05),higher levels of IgG(median:21.0 g/L vs.15.6 g/L,P＜0.05),higher proportions of CD3-CD19+cells[(21.0±11.9)％vs.(13.7±9.6)％,P＜0.05]and lower proportions of CD3+cells[(67.2±14.4)％vs.(76.6％±13.1)％,P＜0.05]than those negative.However,the anti-SSB positive group was less likely to show anti-mitochondrial antibodies(AMA)-M2 positivity(10.5％vs.35.6％,P＜0.05).Glucocorticoids(90.9％vs.73.5％,P＜0.05)and im-munosuppressants(54.5％vs.36.7％,P＜0.05)were more frequently used in anti-SSB positive pSS patients than those negative.Conclusion:The anti-SSB positive pSS patients were younger at disease on-set while more frequently presenting with various symptoms,higher levels of other antibodies and activa-tion of B cells than those negative.Glucocorticoids and immunosuppressants were more frequently used,indicating that anti-SSB positive group presented with a more severe clinal phenotype.关键词
原发性干燥综合征/抗SSB抗体/免疫学特征Key words
Primary Sjögren's syndrome/Anti-SSB antibody/Immunological characteristics分类
医药卫生
