目的 研究抗RNA多聚酶Ⅲ抗体(anti-RNA polymerase Ⅲ antibodies,ARA)相关系统性硬化(systemic sclerosis,SSc)患者的临床特点.方法 纳入2017年1月至2020年12月确诊的SSc患者56例,采用线性免疫印迹法检测ARA,分析其临床特点.结果 56例SSc患者中,ARA(+)8例(14.3％),男∶女为5∶3,中位年龄54岁,中位病程12个月,临床分型以弥漫性SSc为主(62.5％).其中雷诺现象(62.5％)、甲周毛细血管特征性改变(62.5％)、肺间质纤维化(50.0％)是ARA(+)患者最常见的三大临床表现.与ARA(-)组相比,ARA(+)组男性比例显著升高(62.5％vs.10.4％,P=0.003),病程更短(12月vs.66月,P=0.006),并发肿瘤的概率更高(37.5％vs.0％,P=0.002),而雷诺现象发生率更低(62.5％vs.97.9％,P=0.008).将患者按ARA(+)、ATA(+)、ACA(+)分为三组,并行两两组间比较发现:ARA(+)组与AT A(+)组相比,各项临床特征差异无统计学意义(P＞0.017);与ACA(+)组相比,ARA(+)组男性多见,肿瘤更常见,雷诺现象较少见,差异均具有统计学意义(P＜0.017).结论 ARA(+)SSc在临床上更需早期识别并积极诊治,ARA应作为SSc临床常规检测手段.

目的 探究血清Dickkopf-1 (DKK-1)水平与系统性硬化(SSc)发病及病情严重程度的相关性.方法 选取SSc患者19例及健康人18例,用酶联免疫吸附测定(ELISA)法测量DKK-1水平,并与各项临床指标进行相关性分析.结果 SSc患者血清DKK-1高于对照组(P＜0.05),在亚组分析中,DKK-1水平与内脏受累无明显相关性,但与mRSS评分呈中度相关(r=0.584,P＜0.05).此外,DKK-1水平与骨密度水平不相关.结论 血清DKK-1水平与SSc的发病有一定的相关性,且参与皮肤纤维化的发展过程,可作为SSc中病情评价的指标和作用靶点.

Objective To characterize the clinical features of patients with high level of carbohydrate antigen (CA)724 in order to facilitate the recognition of this clinical manifestations.Methods Eight-two cases of hospitalized patients diagnosed with gout were selected and divided into 2 groups according to the level of CA724,and the clinical features and laboratory indexes were compared between the 2 groups.T test was used in the numerical variable data between groups,x2 test was used in the categorical variable data.Correlation analysis was tested using Spearman analysis.Results The incidence of gout stones in the group with high level of CA724 was 61％,which was significantly higher than that in the group of normal CA724 of 28％.There were statistically significant differences between the two groups (x2=8.894,P＜0.05).The incidence of kidney stones in the group with high level of CA724 was 65％,which was significantly higher than that in the group of normal CA724 of 22％.There were statistically significant differences between the two groups (x2=15.013,P＜0.05).But there were no statistically significant differences in age of onset,blood uric acid,erythrocyte sedimentation rate,and serum creatinine between the two groups (P＞0.05).Conclusion The significantly elevated level of CA724 canappeare in gout patients,But it isnotcorrelated with tumor,which should be paid attention by clinician.It helps to avoid unnecessary checks and reduce the psychological and financial burden of patients.

目的 研究干燥综合征患者血清β-2微球蛋白水平与自身抗体产生、腺外受累的相关性.方法 对167例干燥综合征患者的β-2微球蛋白水平、自身抗体进行检测,评估其腺外受累情况,对自身抗体阳性组和阴性组的β-2微球蛋白水平,有腺外表现组和无腺外表现组的β-2微球蛋白水平采用方差分析等方法进行统计学比较.结果 抗SS-A、抗SS-B抗体阳性组和单独抗SS-A阳性及全阴性的β-2微球蛋白水平分别为(2.46±0.90)mg/L、(1.81±0.90)mg/L和(1.45±0.61)mg/L,差异有统计学意义(P＜0.05);有腺外受累组和无腺外受累组的β-2微球蛋白水平分别是(2.42±0.91)mg/L和(1.71±0.83)mg/L,差异有统计学意义(P＜0.05).结论 β-2微球蛋白与自身抗体和系统受累相关,可以作为干燥综合征的一个有用的活动性指标.

目的 探讨系统性硬化症(SSc)重叠原发性胆汁性肝硬化(PBC)患者的临床及免疫学特征.方法 回顾性分析9例SSc合并PBC病例的临床及实验室资料,并与156例单纯SSc病例进行比较.结果 SSc合并PBC患者有更高的血清抗着丝点抗体(ACA)阳性率(P＜0.05).虽然SSc合并PBC更易出现毛细血管扩张(P＜0.05),但与CREST综合征的其他特征的差异无统计学意义,与其他硬皮病相关表现差异无统计学意义.SSc合并PBC多合并干燥综合征(P＜0.05).结论 SSc合并PBC以局限皮肤型硬皮病多见,筛查ACA、抗线粒体抗体(AMA)、AMA-M2可早期识别SSc合并PBC,早期干预有助改善预后.