| Objective:A retrospective case-control study was conducted by investigating the differences of clinical characteristic between in-patients of systemic sclerosis(SSc)with anti-Scl70 antibody positive and anti-Scl70 antibody negative during the 28 year-duration in order to improve the knowledge and diagnosis of systemic sclerosis.Methods:Medical records of patients hospitalized for SSc in the Second Affiliated Hospital of Kunming Medical University from January 1990 to February 2018 were reviewed.Cases were divided into two groups:anti-Scl70 antibody positive group and anti-Scl70 antibody negative group according to whether their anti-Scl70 antibody was positive or not.General information,onset condition,initial symptoms,course of disease,main laboratory examinations,autoantibody examinations,imaging examinations and main therapeutic medications of patients at the last hospital stay were collected.According to the data type and purpose,statistical methods such as t-test,chi-square test,rank sum test,Fisher's exact probability method and Kendall's tau-b(k)correlation analysis were conducted to compare the statistical differences between the two groups.Results:1.There were 142 SSc patients who met the inclusion criteria out of which 75 were females(52.8%)and 67 were males(47.2%)with the ratio(F:M)of 1.12:1.There were 72 cases(M 35,F 37)with positive anti-Scl70 antibody and 70 cases(M 32,F 38)with negative anti-Scl70 antibody.The percentage of minority SSc patients in anti-Scl70 antibody positive group was higher than that of anti-Scl70 antibody negative group(27.8%vs 8.6%,p=0.003).2.In this study,the positive rate of anti-Scl70 antibody was as high as 50.7%.Patients with anti-Scl70 antibody-positive group had more diffuse cutaneous SSc than that of anti-Scl70 antibody negative group(70.8%vs 44.3%,P=0.001).Patients with positive anti-Scl70 antibodies had higher SSc classification scores(14.63±227 points vs 11.40±2.72 points,p<0.001)and the interval from onset to diagnosis was shorter than that of negative group(18.58±21.80 months vs 30.93±43.38 months,P=0.035).Patients with positive anti-Scl70 antibody were more likely to develop interstitial lung diseases(48.6%vs 20.0%,p<0.001).3.There were more critical cases in positive anti-Scl70 antibody group during hospitalization but there was no statistical significance(31.9%vs 18.6%,p=0.07).The use rate of glucocorticoids,immunosuppressants and anti-fibrosis medications in anti-ScI70 antibody positive group was higher than that in anti-Scl70 antibody negative group,but all differences were not statistically significant.The average hospitalization days in anti-Scl70 antibody positive group were shorter(12.51±7.45 days,vs 17.71±17.89 days,P=0.027).4.Kendall's tau-b(k)correlation analysis showed that with the increase of anti-Scl70 antibody titer,the more likely patients were diffuse cutaneous SSc(R=0.265,P=0.001),the higher the SSe classification score(R=0.440,p<0.001),the shorter the hospitalization days of patients(R=-0.161,p=0.016),and the greater the possibility of ANA positive(R=0.300,P<0.001).With the increase of anti-Scl70 antibody titer,the RNPSm,Ro52,PMscl,centromere B,PCNA,nucleosome,histone and mitochondrial M2 were less likely to be positive(all p<0.05).With the increase of anti-Scl70 antibody titer,the ESR,CRP,complement C4,LDL-C,and PLT values were higher(all p<0.05),the ALB and HDL-C values were the lower(p<0.05),and the incidence of interstitial lung disease were higher(R=0.288,p<0.001).Conclusions:The positive rate of anti-ScI70 antibody was 50.7%in patients with SSc.Anti-Scl70 antibody was closely related to diffuse cutaneous SSc and interstitial lung disease.The patients with positive anti-Scl70 antibody had higher SSc classification score,shorter interval from onset to diagnosis and shorter the average hospitalization days. |
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