Significance Of Anti-?-fodrin Antibody In The Diagnosis Of Sj Gren's Syndrome And The Syndrome Type Of Traditional Chinese Medicine Clinical Research

1 ObjectiveThis subject examined the expression of anti-?-fodrin antibody in Sj?gren's syndrome patients,studied the diagnostic significance of anti-?-fodrin antibody against Sj?gren's syndrome,To investigate the relationship between anti-?-fodrin antibody and disease activity in patients with Sjogren's syndrome and the relationship between anti-?-fodrin antibody and other related indicators and TCM syndrome differentiation of Sjogren's syndrome.2 Methods2.1 Theoretical studyIn this paper,through the study of related literature,the value of anti-?-fodrin antibody in the diagnosis of Sjogren's syndrome was discussed,and its relationship with the disease activity of Sjogren's syndrome and its role in TCM syndrome differentiation.2.2 Clinical study Studying on March 2016 to May 2017 in anhui province hospital of traditional Chinese Medicine patients with primary sjogren's syndrome and secondary sjogren's syndrome a total of 60 cases,and other connective tissue in patients with dry mouth or dry eye symptoms,30 cases ruled out secondary sjogren's syndrome may;And 20 healthy persons were selected as healthy control group from anhui province hospital of traditional Chinese Medicine health examination center?The patient was observed to anti-?-fodrin antibody and other related indicators.anti-?-fodrin antibody,interleukin-1?(IL-1?),tumor necrosis factor-?(TNF-?),interleukin-6(IL-6),interleukin-10(IL-10),are detected by using ELISA kits.The Erythrocyte Sedimentation Rate(ESR)was determined by the wei method.CRP,IgG,IgA and IgM were determined by immunoturbidimetry.The quantitative standard of TCM syndrome integration: based on the formulation of the guidelines for the clinical study of new drugs in TCM,a questionnaire was used to determine the TCM syndromepoints of patients.The relationship between anti-?-fodrin antibody and the disease activity degree of SS patients,and the relationship between anti-?-fodrin antibody and other related indicators and the TCM syndrome differentiation of SS patients.The above indexes were used the statistical software SPSS22.0 for analysis.3 Results3.1 Changes of the anti-?-fodrin antibody in patients with SS3.1.1 Compare the positive rate of anti-?-fodrin antibody in SS patients and control groupAmong 60 patients with Sj?gren's syndrome,40 patients in the pSS group had significantly higher serum anti-?-fodrin antibody than other groups(P<0.01);20patients in the sSS group and CTD patients in 30 patients,CTD patients had obvious symptoms of dry mouth or dry eyes,and secondary Sjogren's syndrome was excluded.The positive rate of anti-?-fodrin antibody was significantly higher than that of the normal control group(P<0.01).There was no significant difference in the positive rate of anti-?-fodrin antibody between sSS group and CTD group(P>0.05).The specificity of the anti-?-fodrin antibody in the diagnosis of SS patients was 90%.3.1.2 Comparison of positive rate of each antibody in SS patientsThe positive rate of anti-?-fodrin antibody in 40 patients with pSS was higher than that of the other three antibodies,and the difference was statistically significant compared with that of anti-SSB antibody(P<0.01).Anti-?-fodrin antibody was detected in 20 patients in sSS group.The positive rate was higher than that of anti-SSB and RO-52 antibodies,and the difference was statistically significant compared with that of anti-SSB antibody(P<0.01).The positive rate of anti-?-fodrin antibody in pSS group was significantly higher than that of sSS.In the group,the difference was statistically significant(P<0.01).The total positive rate of anti-?-fodrin antibodies in SS patients was higher than the other three antibodies.3.1.3 The results of combined anti-?-fodrin antibody?anti SSA antibody?anti SSB antibody and anti RO-52 antibody in patients with SSCombined detection of anti-SSA,SSB,RO-52,and anti-?-fodrin antibodies showed that the positive rates in both pSS and sSS groups were 95%;the positive rate of the four combined tests was higher than that of a single antibody,or the positive rate of the combined detection with the three antibodies was statistically significant(P<0.05 or P <0.01).Four of the combined tests were negative in 2 of the 40 patients with primary Sjogren's syndrome,and 1 of 20 patients with secondary Sj?gren's syndrome were negative.3.14 When anti SSA antibody?anti SSB antibody and anti RO-52 antibody were negative,test results of anti-?-fodrin antibody in patients with pSSFor patients with pSS in anti-SSA,SSB,RO-52 antibodies,single or combined negative cases,anti-?-fodrin antibodies still have a certain positive rate.3.1.5 When anti SSA antibody?anti SSB antibody and anti RO-52 antibody were negative,test results of anti-?-fodrin antibody in patients with sSSFor sSS patients with anti-SSA,SSB,RO-52 antibodies,single or combined negative cases,anti-?-fodrin antibodies still have a certain positive rate.3.2 Analysis of anti-?-fodrin antibody and other related indicators in patients with SS3.2.1 The relationship between the anti-?-fodrin antibody and the associated inflammatory markers in pSS patientsA total of 40 patients with pSS were detected,of which 32 cases were positive for anti-?-fodrin antibodies and 8 were negative.There was no significant difference in ESR and CRP levels between the two groups(P>0.05).3.2.2 The relationship between the anti-?-fodrin antibody and relevant immunological indicators and Serum complement of pSS patientsThere was no significant difference in the levels of IgG,IgA,IgM,C3,C4,and RF between the anti-?-fodrin positive group and the negative group(P>0.05).3.2.3 The relationship between the anti-?-fodrin antibody and related cytokines in pSS patientsThere was no significant difference in the levels of TNF-?,IL-1?,IL-6 and IL-10 between anti-?-fodrin antibody positive group and negative group(P>0.05).3.2.4 The relationship between the anti-?-fodrin antibody in pSS patients and their examination results of oral cavity and eyeAnti-?-fodrin antibody positive group compared with the negative group,the static salivary flow was reduced,the difference was statistically significant(P<0.05);corneal fluorescence staining score was increased,the difference was statistically significant(P <0.05);tear film The rupture time was shortened and the difference was statistically significant P<0.05).3.2.5 The relationship between the anti-?-fodrin antibody and ESSDAI integral in pSS patientsThere was no significant difference in ESSDAI scores between anti-?-fodrin antibody positive group and negative group(P>0.05)3.2.6 The relationship between the anti-?-fodrin antibody and TCM syndrome integrals in pSS patientsComparing the anti-?-fodrin antibody positive group with the negative group TCM syndrome scores,there was a statistically significant difference(P<0.05)in the symptoms of dry mouth and throat,and there was no significant difference in the remaining symptoms and total scores(P>0.05).3.3 The comparison and correlation analysis of anti-?-fodrin antibody and other related indicators in TCM syndrome differentiation of SS patients.3.3.1 Comparison of expression of two groups patients of anti-?-fodrin antibodyCompared with the yin-deficiency and damp-heat group and the yin deficiency and blood stasis group,the positive rates of anti-?-fodrin antibody in the two groups were 78.9% and 80.9%,respectively,and the difference was not statistically significant(P>0.05).3.3.2 Comparison of related inflammatory markers of two groups patientsThe levels of ESR and CRP in patients with Yin deficiency dampness heat group were significantly higher than those in patients with Yin deficiency blood stasis group,and the difference was statistically significant(P<0.05 or P<0.01).In the yin deficiency dampness heat group,there was no significant difference in ESR and CRP between anti-?-fodrin antibody positive patients and anti-?-fodrin antibody negative patients(P>0.05).In the Yin deficiency blood stasis group,there was no significant difference in ESR,CRP between anti-?-fodrin antibody positive patients and anti-?-fodrin antibody negative patients(P>0.05).3.3.3 Comparison of related immunological indicators and complement of two groups patientsThe levels of IgG in patients with yin deficiency dampness heat group were significantly higher than those in patients with Yin deficiency blood stasis group(P<0.05).The IgA,IgM,C3 and C4 levels in the two groups were compared.There was no significant difference in levels(P>0.05).In the yin deficiency dampness heat group,the level of C4 in the serum of patients with anti-?-fodrin antibodies was higher than that of negative patients with anti-?-fodrin antibodies,and the difference was statistically significant(P<0.05).There was no significant difference in other related immunological indicators and complement(P>0.05).In the Yin deficiency blood stasis group,anti-?-fodrin antibody-positive patients and anti-?-fodrin antibody-negative patients had anti-?-fodrin antibody positive IgA levels higher than those of negative patients,and the difference was statistically significant.(P<0.05).There was no significant difference in other related immunological indicators and complement(P>0.05).3.3.4 Comparison of cytokines in the two groups patientsThe levels of TNF-? in patients with yin deficiency and damp-heat were significantly higher than those in patients with Yin deficiency blood stasis group(P<0.05).There was no significant difference in the levels ofof IL-1?,IL-6 andIL-10(P>0.05).In the yin deficiency dampness heat group,there was no significant difference in the levels of cytokines TNF-?,IL-1?,IL-6,IL-10 between anti-?-fodrin-positive patients and anti-?-fodrin antibody-negative patients(P<0.05).In the Yin deficiency blood stasis group,there was no significant difference in the levels of cytokines TNF-?,IL-1?,IL-6,IL-10 between anti-?-fodrin-positive patients and anti-?-fodrin antibody-negative patients(P>0.05).3.3.5 Comparison of their examination results of oral cavity and eye of two groups patientsThe scores of corneal fluorescence staining in patients with yin deficiency dampness heat group than those in patients with Yin deficiency blood stasis group(P<0.05).The tear film rupture time was observed in patients with yin deficiency dampness heat group than Yin deficiency blood stasis group decreased,the difference was statistically significant(P<0.05);there was no significant difference in static salivary flow between the two groups(P>0.05).In the yin deficiency dampness heat group,the membrane disruption time of anti-?-fodrin antibody-positive patients was lower than that of anti-?-fodrin antibody negative patients,and the difference was statistically significant(PP<0.01).In the Yin deficiency blood stasis group,the corneal fluorescence staining score of anti-?-fodrin antibody positive patients was higher than that of anti-?-fodrin antibody negative patients,and the difference was statistically significant(P<0.01);the patients with anti-?-fodrin antibody positive were in tears Membrane rupture time was significantly lower than that of anti-?-fodrin antibody negative patients(P<0.05),and the salivary flow of anti-?-fodrin positive patients was lower than that of anti-?-fodrin antibody negative patients,and the difference was statistically significant(P<0.05).3.3.6 Comparison of ESSDAI integral between the two groups patientsCompared with the yin deficiency dampness heat group and Yin deficiency blood stasis group the ESDAI score in the yin deficiency dampness heat group was higherthan that in the Yin deficiency blood stasis group,and the difference was statistically significant(P<0.05).In the yin deficiency dampness heat group and the Yin deficiency blood stasis group,the expression of anti-?-fodrin antibody was not associated with the ESSDAI score,and the difference was not statistically significant(P>0.05).3.3.7 Comparison of TCM syndromes integral in two groups of patientsComparing yin deficiency dampness heat group with Yin deficiency blood stasis group,there was no significant difference in total scores of TCM symptoms between the two groups(P>0.05).However,the scores of oral mucosa,fever and night sweats,salivary gland swelling,and fever scores,fatigue and tiredness,the yin deficiency dampness heat group was higher than theYin deficiency blood stasis group,and the difference was statistically significant(P<0.05 or P<0.01).In terms of joint pain scores,body weight loss points,Yin deficiency blood stasis group was higher than the yin deficiency dampness heat group,and the difference was statistically significant(P<0.05).In the yin deficiency dampness heat group,there was no significant difference in the total score of TCM symptoms between the patients with positive anti-?-fodrin antibody and negative patients(P>0.05).However,anti-?-fodrin antibody-positive patients had higher scores in tongue integrals and salivary gland adenopathy than anti-?-fodrin antibody negative patients,and the difference was statistically significant(P<0.05).There was no significant difference in other indicators(P>0.05).In the yin deficiency and blood stasis group,there was no significant difference in the total scores of TCM symptoms between patients with positive anti-?-fodrin antibodies and negative patients(P>0.05).However,patients with positive anti-?-fodrin antibodies were more likely to have anti-?-fodrin antibody negative than patients with negative anti-?-fodrin antibodies,and the difference was statistically significant(P<0.05).There was no significant difference in other indicators(P>0.05).4 Conclusion4.1 The anti-?-fodrin antibody can be used as a clinical auxiliary diagnosis of SS,and it has certain supplementary diagnostic significance when other antibodies are negative.4.2 There was no significant correlation between anti-?-fodrin antibody and disease activity index of SS patients.There was no significant significance in the evaluation of SS patients' disease,but there was a certain correlation with the oral and eye examination of patients.4.3 There was no significant correlation between anti-?-fodrin antibody and syndrome differentiation of Sjogren's syndrome,But,in the yin deficiency dampness heat group the Anti-?-fodrin antibodies correlate with patient's C4 level,membrane rupture time,tongue integral scores and salivary adenoid scores in TCM symptoms.in the in deficiency blood stasis group the anti-?-fodrin antibodies had certain correlation with the level of IgG in patients,the score of corneal fluorescence staining,the time of membrane rupture,the measurement of salivary flow,and the dry mouth and throat scores in TCM symptoms.4.4 SS patients' ESR,CRP,IgG,TNF-?,corneal fluorescence staining scores,Membrane rupture time,ESSDAI scores and in TCM syndrome the scores of oral mucosa,fever and night sweats,salivary gland swelling score,fever score,body tiredness fatigue,joint pain score,body weight losst.It has a certain correlation with TCM syndrome differentiation.