抗Ro-52抗体阳性的抗合成酶综合征2例报告及文献复习

Vol.45No.4Jul.2019935第45卷第4期2019年7月吉林大学学报(医学版)JournalofJilinUniversity(MedicineEdition)［文章编号文章编号］1671-587!(2019)04-0935-05DOI：10.13481/j.1671-587x.20190434抗Ro-52抗体阳性的抗合成酶综合征2例报告及文献复习宿凯笙，赵令，冯秀南，姜振宇(吉林大学第一医院风湿免疫科，吉林长春,130021)［摘要［摘要］目的：分析抗Ro-52抗体阳性的抗合成酶综合征(ASS)患者的诊疗过程，总结抗Ro-52抗体与ASS的关系，阐明其临床意义。方法：收集2例抗Ro-52抗体阳性ASS患者的临床资料,分析其临床特征，结合相关文献复习探讨抗Ro-52抗体与ASS的关系。结果：2例年轻女性患者均因明显的双手关节症状入院，查体可见双手关节肿胀,呈“技工手样改变，四肢肌力及肌张力正常。肌酸激酶活性升高。均行肌炎抗体谱、肺CT、肌电图和肌肉活检等辅助检查，确诊后给予相关治疗。2例患者肌炎抗体谱均为抗Jo1抗体和抗Ro-52抗体强阳性，肺CT显示间质性肺疾病(ILD),肌电图提示肌源性损害,肌肉活检均符合特发性炎症性肌病改变。2例患者均明确诊断为ASS,给予糖皮质激素及免疫抑制剂治疗后症状好转，肌酸激酶活性降低,随访至今未见疾病活动及继发肿瘤征象。结论：抗Ro-52抗体作为一种肌炎相关性抗体，可导致ASS患者岀现一系列不典型的临床表现，并可能与患者不良预后有关联,应密切随访。［关键词关键词］抗Ro-52抗体；抗合成酶综合征；肌炎相关性抗体；肌酸激酶；间质性肺疾病［中图分类号中图分类号］R593.26［文献标志码文献标志码］BAntisynthetasesyndromewithpositiveanti・Ro52antibody:Areportof2casesandliteraturereviewSUKaisheng,ZHAOLing,FENGXiunan,JIANGZhenyu(DepartmentofRheumatology,FirstHospital,JilinUniversity,Changchun130021,China)ABSTRACTObjective：Tosummarizetherelationshipbetweenanti-Ro-52antibodyandanti-synthasesyndrome(ASS)byanalyzingthediagnosisandtreatmentofASSpatientswithpositiveanti-Ro-52antibody,andtoclarifyitssignificance.Methods：Theclinicalmaterialsof2ASSpatientswithpositiveanti-Ro52antibodywerecollected,andtheclinicalcharacteristicswereanalyzed;combinedwithliteraturereview,therelationshipbetweenanti-Ro-52antibodyandASSwasexplored.Results：Twoyoungfemalepatientswereadmittedtohospitalbecauseoftheobvioussymptomsofbothhandjoints.Onphysicalexamination,arthroncusofbothhandjointswasobserved,bothhandsshowed“mechanichand,musclestrengthandmuscletensionoflimbswerenormal.Theactivityofcreatinekinasewasincreased.Myositisantibodyspectrum,lungCT,electromyographyandmusclebiopsywereperformedandthepatientsweregiventherelatedtreatments.afterconfirmeddiagnosis.Theanti-Jo-1andanti-Ro-52antibodieswerestronglypositiveinthemyositisantibodyspectrumofthetwopatients;thelungCTresultsshowedinterstitialpheumonia；theelectromyogramresultsindicatedmyogenicdamage；theresultsofmusclebiopsywascons