摘要：
目的 通过检测唇腺免疫球蛋白(Ig)G及其亚类以进一步探讨SS的发病机制.方法 免疫组织化学法检测70例SS患者唇腺IgG及其亚类的表达水平并收集临床资料分析与其相关性;计量资料正态分布者组间比较用t检验,非正态分布采用U检验,计数资料的显著性检验采用χ2检验.结果 70例SS患者唇腺IgG阳性36例(51％),IgG1阳性32例(46％),IgG2阳性3例(4％),IgG3阳性5例(7％),IgG4阳性6例(9％);IgG1阳性组的病程长于阴性组[(74±75)个月与(25±36)个月,t=3.57,P<0.05],白细胞较阴性组低[(5.5±2.5)×109/L与(7.3±3.6)×109/L,t=2.38,P均<0.05],ANA、抗SSA、SSB抗体阳性率高于IgG1阴性组(分别为97％与74％,93％与65％,47％与15％,χ2分别为6.08,7.46,8.22,P均<0.05),病理活检为Chisholm3/4级的比例高于IgG1阴性组(97％与67％,χ2=9.22,P<0.05).结论 SS患者唇腺浸润的主要IgG亚类为IgG1;IgG1的优势表达与病理损伤相关联,可能参与了SS患者唇腺局部的免疫炎性损伤过程从而促进疾病进展.%Objective The purpose of this study was to clarify the distribution of immunoglobulin (Ig) G subclasses in the salivary glands of Sj?gren's syndrome (SS). Methods The salivary glands from 70 patients were stained with IgG and IgG subclasses monoclonal antibodies. Clinical data was collected and analyzed between different groups. For group comparisons,measurement data were compared using Student's t test and Mann-Whitney U test, while count data were measured using chi-square test. Results All four IgG subclasses could be detected. IgG could be detected in 36 patients (51％), IgG1 in 32 patients (46％), IgG2 in 3 patients (4％), IgG3 in 5 patients (7％), and IgG4 in 6 patients (9％). IgG1 positive group appeared to have longer duration [(74±75) months (25±36) months, t=3.57, P<0.05), lower white blood cell count (WBC) [(5.5±2.5)×109/L vs (7.3±3.6)×109/L, t=2.38, P<0.05), higher positive rate for antinuclear antibody (ANA), anti-SSA, anti-SSB (97％ and 74％, 93％ and 65％, 47％ and 15％, χ2 was 6.08, 7.46, 8.22 respectively, P<0.05) and more Chisholm 3/4 pathological grade cases (97％与 67％, χ2=9.22), They were all stastically significant (P<0.05). Conclusion IgG1 is the main IgG subclass in the salivary glands of SS. IgG1 may take part in the immunological injury of salivary glands destruction in SS;The dominant IgG1 expression in the salivary glands of SS correlates with pathological injury.
