{
  "abstract": "目的: 原发性干燥综合征(primary Sjögren syndrome，pSS)是一种以B细胞过度活化为特征的慢性自身免疫病，类风湿因子(rheumatoid factor，RF)在pSS中阳性率较高，但RF亚型的临床意义尚不明确，且既往研究多未严格排除合并类风湿关节炎(rheumatoid arthritis，RA)的患者。本研究旨在探讨RF-免疫球蛋白A(immunoglobulin A，IgA)阳性且不伴RA的pSS患者的免疫表型特征及其与疾病活动度的关系。\n\n方法: 纳入2021年1月至2025年12月于贵州中医药大学第二附属医院风湿免疫科就诊的153例pSS患者，其中RF-IgA阳性组30例，阴性组123例。采用流式细胞术检测外周血淋巴细胞亚群比例；流式细胞微球阵列法检测血清白细胞介素(interleukin，IL)-6、IL-10、IL-17A、干扰素(interferon，IFN)-γ、肿瘤坏死因子(tumor necrosis factor，TNF)-α及IL-1β水平；免疫比浊法检测免疫球蛋白及补体水平；间接免疫荧光法检测抗干燥综合征A型抗原(Sjögren syndrome-related antigen A，SSA)/60 kD、抗SSA/52 kD及抗干燥综合征B型抗原(Sjögren syndrome-related antigen B，SSB)/La抗体。采用欧洲抗风湿病联盟干燥综合征疾病活动指数(European League Against Rheumatism Sjögren’s Syndrome Disease Activity Index，ESSDAI)评估疾病活动度，比较2组间肺间质肺炎、淋巴瘤及甲状腺疾病等并发症发生率。采用Spearman相关分析评估RF-IgA阳性组中RF-IgA水平与分化簇(cluster of differentiation，CD)19⁺ B细胞百分比及血清IgA和IgG水平的相关性。\n\n结果: RF-IgA阳性组CD19⁺ B细胞比例高于阴性组，CD8⁺ T细胞比例低于阴性组，CD4/CD8比值高于阴性组(均P<0.05)；2组CD4⁺ T细胞及自然杀伤(natural killer，NK)细胞比例差异均无统计学意义(均P>0.05)。RF-IgA阳性组IgA及IgG水平均高于阴性组(均P<0.05)，2组IgM水平差异无统计学意义(P>0.05)。RF-IgA阳性组抗SSA/60 kD、抗SSA/52 kD及抗SSB/La抗体阳性率均高于阴性组(均P<0.05)。2组间6种细胞因子、补体C3和C4水平的差异均无统计学意义(均P>0.05)。2组ESSDAI及并发症肺间质肺炎、甲状腺疾病、慢性胃炎、肾损伤发生率的差异均无统计学意义(均P>0.05)。Spearman相关分析显示，RF-IgA水平与IgA(r=0.609，P<0.001)及IgG(r=0.376，P=0.041)呈正相关，与CD19⁺ B细胞比例的相关性无统计学意义(r=0.106，P=0.557)。\n\n结论: 不伴RA的RF-IgA阳性pSS患者存在B细胞扩增、CD8⁺ T细胞减少、CD4/CD8比值升高、免疫球蛋白及抗SSA/SSB抗体水平升高等免疫学改变，提示B细胞活化和体液免疫增强。然而，该免疫活化表型未伴随炎症细胞因子水平的升高、补体水平的下降、ESSDAI的升高或腺外脏器受累的增加。RF-IgA阳性可标记一种以B细胞相关免疫指标改变为特征的血清学表型，该表型未伴随全身性炎症指标升高或疾病活动度增加，RF-IgA阳性的临床意义应审慎解读，不宜直接等同于疾病活动度升高。",
  "abstract_shown": true,
  "affiliations": [],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 6,
  "authors": [
    {
      "name": "梦圆 黎",
      "orcid": "0009-0000-6123-9144"
    },
    {
      "name": "洋 张"
    },
    {
      "name": "樾 王"
    },
    {
      "name": "雷 侯"
    },
    {
      "name": "武开 马"
    },
    {
      "name": "鹏 杨",
      "orcid": "0000-0001-8706-4768"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/bxnjbyrw95mqe.bib",
  "cited_by": 0,
  "doi": "10.11817/j.issn.1672-7347.2026.260269",
  "fulltext_url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC13710872/",
  "id": "bxnjbyrw95mqe",
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    "1672-7347"
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  "landing_url": "https://doi.org/10.11817/j.issn.1672-7347.2026.260269",
  "language": "zh",
  "licence": "CC-BY-NC-ND-4.0",
  "licence_label": "CC BY-NC-ND 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc-nd/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
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      "openalex",
      "2737|Salivary Gland Disorders and Functions"
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  "openalex": "W7223797383",
  "pdf_url": null,
  "pmcid": "PMC13710872",
  "pmid": "42935199",
  "published": "2026-08-28",
  "publisher": "Central South University",
  "ris": "https://research.draconitic.com/paper/bxnjbyrw95mqe.ris",
  "sources": [
    {
      "first_seen": "2026-10-31T12:21:45Z",
      "native_id": "PMC13710872",
      "source": "pmc",
      "url": "https://doi.org/10.11817/j.issn.1672-7347.2026.260269"
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  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2737|Salivary Gland Disorders and Functions",
      "subfield": "physiology"
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  ],
  "title": "RF-IgA阳性原发性干燥综合征免疫表型：B细胞活化与细胞因子静默的解离现象",
  "title_text": "RF-IgA阳性原发性干燥综合征免疫表型：B细胞活化与细胞因子静默的解离现象",
  "type": "peer-reviewed",
  "updated_at": "2026-10-31T12:21:45Z",
  "url": "https://research.draconitic.com/paper/bxnjbyrw95mqe",
  "venue": "Journal of Central South University Medical Sciences",
  "versions": []
}