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抗中性粒细胞胞浆抗体相关性血管炎中 HEp-2 细胞细胞质模式的临床意义。

Clinical significance of HEp-2 cell cytoplasmic patterns in anti-neutrophil cytoplasmic antibody associated vasculitis.

机构信息

Department of Clinical Laboratory, Peoples Hospital of Deyang City, Deyang, China.

Department of Rheumatology, Peoples Hospital of Deyang City, Deyang, China.

出版信息

Medicine (Baltimore). 2022 Jun 24;101(25):e29498. doi: 10.1097/MD.0000000000029498.

Abstract

The study was to investigate the clinical characteristics and significance of antinuclear antibody (ANA) cytoplasmic patterns in ANCA-associated vasculitis (AAV) from Southwest China.A retrospective study including 232 AAV patients from Peoples Hospital of Deyang City was performed. These included 115 patients with ANA cytoplasmic pattern as observation group and 117 patients without ANA cytoplasmic pattern as control group.Chest involvement (60.00 vs 46.15, P = .035), cardiovascular involvement (5.21 vs 29.91, P < .001), and renal involvement (37.39 vs 77.78, P = .001) were different between groups.Total protein (69.55 vs 64.01, P < .001), triglyceride (1.41 vs 1.18, P = .023), mean cell volume (89.76 vs 87.59, P = .040), and estimated glomerular filtration rate (76.67 vs 50.87, P = .035) were higher in ANA cytoplasmic patterns group. Creatinine (73.00 vs 117.50, P = .011), white blood cell (6.93 vs 8.86, P = .001), platelet (196.0 vs 239.0, P = .017), anti-myeloperoxidase (2.44 vs 3.42, P = .042), and anti-proteinase 3 (1.00 vs 4.93, P = .007) were lower in this group. In multivariate analysis, creatinine (odds ratio [OR] = 1.21, 95% confidence interval [CI]: 1.06-1.38), triglyceride (OR = 1.97, 95% CI: 1.10-3.48), and anti-myeloperoxidase (OR = 1.64, 95% CI: 1.37-1.95) were independent risk factors of AAV renal involvement. Total protein (OR = .95, 95% CI: 0.91-0.99) was an independent protective factor of AAV renal involvement. Chi-square test showed that speckled pattern was different among anti-neutrophil cytoplasmic antibody patterns (χ2 = 18.526, P < .001).In summary, HEp-2 cell cytoplasmic patterns have certain clinical significance in AAV, which is a new exploration of the clinical value of ANA.

摘要

本研究旨在探讨中国西南地区抗中性粒细胞胞浆抗体(ANCA)细胞质型在抗中性粒细胞胞浆抗体相关性血管炎(AAV)中的临床特征和意义。

方法

采用回顾性研究方法,纳入德阳市人民医院的 232 例 AAV 患者。其中,115 例为 ANA 细胞质型患者作为观察组,117 例无 ANA 细胞质型患者作为对照组。结果:观察组的胸部受累(60.00% vs 46.15%,P=0.035)、心血管受累(5.21% vs 29.91%,P<0.001)和肾脏受累(37.39% vs 77.78%,P=0.001)与对照组不同。观察组总蛋白(69.55 vs 64.01,P<0.001)、甘油三酯(1.41 vs 1.18,P=0.023)、平均细胞体积(89.76 vs 87.59,P=0.040)和估算肾小球滤过率(76.67 vs 50.87,P=0.035)较高。观察组的血肌酐(73.00 vs 117.50,P=0.011)、白细胞(6.93 vs 8.86,P=0.001)、血小板(196.0 vs 239.0,P=0.017)、抗髓过氧化物酶(2.44 vs 3.42,P=0.042)和抗蛋白酶 3(1.00 vs 4.93,P=0.007)较低。多因素分析显示,血肌酐(比值比[OR] = 1.21,95%置信区间[CI]:1.06-1.38)、甘油三酯(OR = 1.97,95% CI:1.10-3.48)和抗髓过氧化物酶(OR = 1.64,95% CI:1.37-1.95)是 AAV 肾脏受累的独立危险因素。总蛋白(OR=0.95,95% CI:0.91-0.99)是 AAV 肾脏受累的独立保护因素。卡方检验显示,抗中性粒细胞胞浆抗体核周型在抗中性粒细胞胞浆抗体模式中存在差异(χ2=18.526,P<0.001)。

结论

HEp-2 细胞质型在 AAV 中有一定的临床意义,是对 ANA 临床价值的新探索。

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