论文部分内容阅读
目的了解抗Ⅱ型胶原(CⅡ)抗体在类风湿关节炎(RA)中的临床意义及口服鸡CⅡ对血清中抗CⅡ抗体的影响。方法以鸡CⅡ蛋白作为包被抗原,采用酶联免疫吸附试验(ELISA)检测70名健康献血者、113例活动期RA患者,其中病程≤1年的早期患者30例;同时检测19例患者在口服鸡CⅡ90“g/d治疗前和治疗12、24周后血清中的抗CⅡ抗体水平。结果①RA患者血清抗CⅡ抗体水平明显高于健康对照组;RA患者血清抗CⅡ抗体阳性率为37.2%(42/113),正常对照组阳性率为2.9%(2/70),两者比较差异有统计学意义(P<0.01);②早期RA患者抗CⅡ抗体阳性率73.3%(22/30),而病程>1年的RA患者抗CⅡ抗体阳性率为24.1%(20/83),两组差异具有统计学意义(P<0.05);&%比较抗CⅡ抗体阳性组和阴性组其他相关指标:抗CⅡ抗体阳性组42例,阴性组71例,两组类风湿因子(RF)阳性率分别为83.3%(35/42)和43.7%(31/71),两组比较差异有统计学意义(P<0.05);抗环瓜氨酸肽(CCP)抗体阳性率分别为90.5%(38/42)和52.1%(37/71),两组比较差异有统计学意义(P<0.05);同时抗CⅡ抗体阳性组的血沉(ESR)、C反应蛋白(CRP)水平均高于抗CⅡ抗体阴性组;两组在日常生活能力及骨质破坏方面差异无统计学意义;④口服CⅡ治疗前和治疗12、24周后,RA患者血清抗CⅡ抗体水平有逐渐下降趋势,但差异无统计学意义。结论RA患者抗CⅡ抗体明显升高,尤其在早期RA患者有较高的阳性率;抗CⅡ抗体阳性患者RF、抗CCP抗体阳性率明显高于阴性患者,同时ESR、CRP亦明显升高;口服CⅡ治疗后抗体水平有逐渐下降趋势。因此,抗CⅡ抗体在RA发病中可能起着重要的作用,可作为早期诊断、判断病情活动的指标之一;口服CⅡ对CⅡ抗体的影响有待进一步观察。
Objective To investigate the clinical significance of anti-type Ⅱ collagen (CⅡ) antibody in rheumatoid arthritis (RA) and the effect of oral CⅡ on anti-CⅡ antibody in serum. Methods Chickens were immunized with chicken CⅡ protein as antigen and 70 healthy blood donors and 113 active RA patients were enrolled in this study. Thirty patients with early disease ≤ 1 year were enrolled in this study. Twenty-nine patients Serum levels of anti-CⅡ antibody in oral chicken CⅡ90 ”g / d before and 12, 24 weeks after treatment were measured.Results ① The serum level of anti-CⅡ antibody in RA patients was significantly higher than that in healthy controls; the positive rate of anti-CⅡ antibody in RA patients was 37.2 % (42/113), the positive rate of normal control group was 2.9% (2/70), the difference was statistically significant (P <0.01); ② The positive rate of anti-CⅡ antibody in early RA patients was 73.3% ), While the positive rate of anti-CⅡ antibody in RA patients with duration> 1 year was 24.1% (20/83), the difference between the two groups was statistically significant (P <0.05); The positive rates of rheumatoid factor (RF) in the two groups were 83.3% (35/42) and 43.7% (31/71), respectively. The differences between the two groups were statistically significant (P <0.05). The positive rates of anti-cyclic citrullinated peptide (CCP) antibodies were 90.5% (38/42) and 52.1% (37/71) respectively, with significant difference between the two groups ; While anti-C Ⅱ ESR and C-reactive protein (CRP) were higher in the positive group than in the negative group of anti-CⅡ antibody. There was no significant difference in daily living ability and bone destruction between the two groups. ④ Before oral administration of CⅡ and treatment of 12 , The levels of anti-CⅡantibody in RA patients gradually decreased after 24 weeks, but the difference was not statistically significant.Conclusion The anti-CⅡantibody of patients with RA was significantly increased, especially in patients with early RA, and the positive rate of anti-CⅡantibody The positive rate of RF and anti-CCP antibody in patients with RA was significantly higher than that in patients with negative and the ESR and CRP levels were also significantly increased. Antibody level after oral CⅡ treatment tended to decline gradually. Therefore, anti-CⅡ antibody may play an important role in the pathogenesis of RA, Can be used as an early diagnosis, to determine one of the indicators of disease activity; oral C Ⅱ C Ⅱ antibody to be further observed.