系统性自身免疫性疾病（SAD）的高度复杂性阻碍了精确管理。本研究旨在调查SAD的异质性。我们将多重对应分析和k均值结合起来的联合聚类分析应用于免疫标记物，并通过检查免疫标记物和临床表现的差异来测量聚类的异质性。检索了 2001 年至 2016 年间从台湾医院接受抗核抗体检测并被诊断患有系统性红斑狼疮 (SLE)、类风湿性关节炎 (RA) 和干燥综合征 (SS) 的患者的电子健康记录。根据独特的免疫标记物模式，共有 11,923 名患有三种 SAD 的患者被分为六组。没有一个簇仅由单个 SAD 组成，并且这些簇在临床表现上表现出相当大的差异。 SLE 和 SS 患者在六个簇中的分布更加分散。在 SLE 患者中，第 3 组和第 6 组肾脏损害的发生率（52% 和 51%）高于其他组（p<0.001）。集群 3 中盘状狼疮患者的比例 (60%) 也高于集群 6 (39%；p<0.001)。第 3 组中的 SS 患者最为独特，因为与其他组相比，免疫性疾病 (63%) 和其他未特指的良性肿瘤 (58%) 的发生率较高，具有统计学意义（全部 p<0.05）。驱动聚类方法可以识别更多临床相关的 SAD 亚组，并提供更精确的诊断依据。© 2024。作者。

The high complexity of systemic autoimmune diseases (SADs) has hindered precise management. This study aims to investigate heterogeneity in SADs.We applied a joint cluster analysis, which jointed multiple correspondence analysis and k-means, to immunomarkers and measured the heterogeneity of clusters by examining differences in immunomarkers and clinical manifestations. The electronic health records of patients who received an antinuclear antibody test and were diagnosed with SADs, namely systemic lupus erythematosus (SLE), rheumatoid arthritis (RA), and Sjögren's syndrome (SS), were retrieved between 2001 and 2016 from hospitals in Taiwan.With distinctive patterns of immunomarkers, a total of 11,923 patients with the three SADs were grouped into six clusters. None of the clusters was composed only of a single SAD, and these clusters demonstrated considerable differences in clinical manifestation. Both patients with SLE and SS had a more dispersed distribution in the six clusters. Among patients with SLE, the occurrence of renal compromise was higher in Clusters 3 and 6 (52% and 51%) than in the other clusters (p < 0.001). Cluster 3 also had a high proportion of patients with discoid lupus (60%) than did Cluster 6 (39%; p < 0.001). Patients with SS in Cluster 3 were the most distinctive because of the high occurrence of immunity disorders (63%) and other and unspecified benign neoplasm (58%) with statistical significance compared with the other clusters (all p < 0.05).The immunomarker-driven clustering method could recognise more clinically relevant subgroups of the SADs and would provide a more precise diagnosis basis.© 2024. The Author(s).