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目的探讨异质性胞核核糖核蛋白A2(hnRNP A2)在类风湿关节炎(Rheumatoid Arthritis,RA)诊断中的临床意义,建立简便、快捷的ELISA检测方法,并与国外Anti-RA33 Ab试剂盒的结果对比,以作为验证国内试剂盒可用性的依据。方法以高纯度的具有抗原反应性的重组hnRNP A2蛋白作为抗原,对临床上包括137例RA在内的多种结缔组织病患者的血清中的相应抗体进行ELISA检测。应用国外Anti-RA33 Ab试剂盒ELISA法检测并对比检测结果。结果hnRNP A2在RA患者中的敏感性为37.23%,特异性为85.44%,抗hnRNP A2/RA33抗体在RA患者中阳性率均明显高于其他疾病组(P<0.05)。抗hnRNP A2/RA33抗体在早期RA患者中的阳性率为43.75%。与国外Anti-RA33 Ab试剂盒检测结果比较,在各组患者中检测抗RA33抗体的阳性率无明显差别(P>0.05),且总体符合率高达86.88%。另外,该抗体与年龄、病程、晨僵时间、血沉、C反应蛋白、关节功能、X线分期、类风湿因子(RF)、抗角蛋白抗体(AKA)、抗核周因子抗体(APF)及抗CCP抗体之间均无相关性(P>0.05)。结论我们初步纯化了RA33抗原,对hnRNP A2进行了基因的克隆、重组蛋白的表达和纯化,并以其为抗原,用ELISA方法检测抗hnRNP A2/RA33抗体是早期诊断RA的可靠方法。与国外Anti-RA33 Ab试剂盒的检测结果对比无明显差异,自制的抗RA33抗体试剂盒可以可靠地应用于临床检验。
Objective To investigate the clinical significance of heterogeneous nuclear ribonucleoprotein A2 (hnRNP A2) in the diagnosis of rheumatoid arthritis (RA) and to establish a simple and rapid ELISA method for its detection. The anti-RA33 Ab kit The results of the comparison, as a validation of the availability of domestic kit basis. Methods Using the highly purified antigen-reactive recombinant hnRNP A2 protein as an antigen, the corresponding antibodies in serum of various connective tissue disease patients including 137 RA patients were tested by ELISA. The foreign Anti-RA33 Ab kit ELISA test and compare the test results. Results The sensitivity and specificity of hnRNP A2 in RA patients were 37.23% and 85.44% respectively. The positive rates of anti-hnRNP A2 / RA33 antibodies in RA patients were significantly higher than those in other disease groups (P <0.05). The positive rate of anti-hnRNP A2 / RA33 antibody in patients with early RA was 43.75%. Compared with the detection results of Anti-RA33 Ab kit in foreign countries, the positive rate of anti-RA33 antibody in each group was no significant difference (P> 0.05), and the overall coincidence rate was as high as 86.88%. In addition, the antibody correlated with age, course of disease, morning stiffness, erythrocyte sedimentation rate, C-reactive protein, joint function, X-ray staging, rheumatoid factor (RF), anti-keratin antibody (AKA), anti-nuclear factor antibody (APF) There was no correlation between anti-CCP antibodies (P> 0.05). Conclusion Our preliminary purification of RA33 antigen, hnRNP A2 gene cloning, recombinant protein expression and purification, and as an antigen, ELISA detection of anti-hnRNP A2 / RA33 antibody is a reliable method for the early diagnosis of RA. Compared with foreign Anti-RA33 Ab kit test results no significant difference, homemade anti-RA33 antibody kit can be reliably applied to clinical testing.