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目的研究类风湿关节炎(RA)患者抗环瓜氨酸肽抗体(CCP抗体)与肿瘤坏死因子(TNF)-α、类风湿因子(RF)、红细胞沉降率(ESR)、血小板计数(PLT)及临床的相关性,以及未分类关节炎(痛)患者6个月后随访转归情况,探讨其在RA早期诊断及发病机制中的意义。方法对9l例RA患者,46例未分类关节炎(痛)患者,45例其他风湿病患者,应用酶联免疫吸附试验(ELISA)法检测血清抗CCP抗体、TNF-α,速率散射免疫比浊法检测RF。结果RA组及未分类关节炎(痛)组患者外周血抗CCP抗体水平与TNF-α水平、PLT、关节肿胀度呈显著正相关(r=0.854,P=0.000;r=0.882,P=0.000;r=0.318,P=0.002;r=0.486,P=0.001;r=0.291,P=0.005;r=0.731,P=0.000),RA组及未分类关节炎(痛)组患者外周血抗CCP抗体水平分别与握力呈弱负相关(r=-0.228,P=0.030)、与ESR呈弱正相关(r=0.365,P=0.013);RA组及未分类关节炎(痛)组患者外周血抗CCP抗体水平明显高于其他风湿病组患者(P=0.000);其他风湿病组患者外周血抗CCP抗体水平高于正常组对照组(P=0.011)。46例未分类关节炎(痛)组患者有24例抗CCP抗体阳性,6个月后随访,有32例为早期RA,抗CCP抗体在早期RA的阳性率为72%(23/32),96%(23/24)的未分类关节炎(痛)组抗CCP抗体阳性患者为早期RA。结论抗CCP抗体反映了RA一定的病情活动性;可用于RA早期诊断及利于早期RA的鉴别诊断;抗CCP抗体水平升高,伴有TNF-α、ESR、PLT升高及关节肿胀时,有助于RA早期诊断。
Objective To investigate the relationship between anti-cyclic citrullinated peptide antibody (CCP) and tumor necrosis factor (TNF) -α, rheumatoid factor (RF), erythrocyte sedimentation rate (ESR), platelet count (PLT) And clinical correlation, as well as the follow-up and prognosis of patients with unsorted arthritis (pain) after 6 months to explore its significance in the early diagnosis and pathogenesis of RA. Methods Ninety-one patients with RA, 46 patients with undifferentiated arthritis (pain) and 45 patients with other rheumatism were tested for serum anti-CCP antibody, TNF-α, France test RF. Results The levels of anti-CCP antibody in peripheral blood of patients with RA and non-differentiated arthritis (pain) group were positively correlated with TNF-α, PLT and joint swelling (r = 0.854, P = 0.000; r = 0.882, P = r = 0.183, P = 0.001; r = 0.189, P = 0.000; r = 0.731, P = 0.000). In peripheral blood of patients with RA and nonspecific arthritis (pain) (R = -0.228, P = 0.030) and weakly positive correlation with ESR (r = 0.365, P = 0.013). The peripheral blood of patients in RA group and non-classified arthritis (pain) The anti-CCP antibody levels were significantly higher in patients with other rheumatic diseases than those in other rheumatic diseases patients (P = 0.000). The levels of anti-CCP antibodies in peripheral blood of other rheumatic diseases patients were significantly higher than those in the control group (P = 0.011). The anti-CCP antibody was positive in 24 cases of unclassified arthritis (pain) group. Six months later, 32 cases were early RA. The positive rate of anti-CCP antibody in early RA was 72% (23/32) 96% (23/24) of the unclassified arthritis (pain) group were positive for anti-CCP antibody as early RA. Conclusion The anti-CCP antibody reflects the activity of RA. It can be used in the early diagnosis of RA and the differential diagnosis of early RA. The anti-CCP antibody level is elevated with the increase of TNF-α, ESR, PLT and joint swelling To help early diagnosis of RA.