抗着丝点抗体阳性自身免疫性疾病患者临床及免疫学特征分析

目的:分析抗着丝点抗体(ACA)阳性自身免疫性疾病患者特征。方法:回顾性分析我院皮肤科2020年1月至2021年6月间接免疫荧光法检测ACA自身免疫性疾病的患者,分为ACA阳性组和ACA阴性组,比较两组性别、年龄、临床诊断、抗核抗体谱、免疫学指标、临床表现等。结果:共分析ACA阳性自身免疫性疾病患者53例,ACA阴性患者31例。ACA阳性组平均年龄(59.85±11.79)岁高于ACA阴性组(49.06±16.60)岁(P<0.05);ACA阳性组高滴度(≥1∶1000)、抗CENP-B抗体、抗AMA-M2抗体阳性占比分别为98.11%、94.34%和22.64%,高于ACA阴性组的77.42%、6.45%和6.45%(P_s<0.05);ACA阳性组血清IgG水平(11.22±5.36)g/L低于ACA阴性组(P<0.05);ACA阳性患者雷诺现象(43.40%)、心血管受累(33.96%)发生率高于ACA阴性组(P<0.05)。结论:ACA阳性的自身免疫性疾病患者具有发病年龄晚、ACA检出滴度高,易出现雷诺现象、心血管受累,抗AMA-M2、CENP-B抗体检出率高、血清IgG降低的特征,ACA在自身免疫性疾病中致病机制值得更进一步的研究。

Analysis on immunological and clinical characteristics of anti centromere antibody positive patients with autoimmunity disease

Objective: To analyse the characteristics of the anti-centromere antibody (ACA) positive patients with autoimmunity disease. Methods: The data of the autoimmunity disease patients with anti-centromere antibody (ACA) detected by indirect immunofluorescence in our hospital from January, 2020 to June 2021 were analyzed retrospectively. The patients were divided into ACA positive group and ACA negative group, and the gender, age, clinical diagnosis, antinuclear antibody spectrum, immunological index, manifestations were compared between the two group. Results: 53 cases with ACA positive and 31 cases with ACA negative were analyzed. The average age of ACA positive group was 59.85±11.79, which was higher than ACA negative group (P＜0.05). The proportion of high titer（≥1∶1000）of ACA antibody titer, anti CENP-B antibody and anti AMA-M2 antibody in ACA positive gruop was 98.11%, 94.34% and 22.64%, which were higher than those in ACA negative gruop (77.42%, 6.45% and 6.45%) (Ps＜0.05). The average serum IgG level was 11.22±5.36 g/L in ACA positive group which was lower than ACA negative group (P<0.05). The ratio of the patients with Raynaud's phenomenon, cardiovascular involvement was 43.40% and 33.96% in ACA positive group, which was higher than those in ACA negative group (P<0.05). Conclusion:The characteristics of ACA positive patients with autoimmunity disease include older onset age, higher ACA antibody titer, AMA-M2 antibody level and CENP-B antibody level, easy to complicated with Raynaud's phenomenon and cardiovascular diseases, lower serum IgG level. The pathogenesis mechanism of ACA in autoimmunity diseases deserves more deeply study.