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目的检测不同风湿性疾病患者血清中抗异质性胞核核糖核蛋白A2(hnRNPA2)/类风湿关节炎(RA)33抗体,探讨其在风湿性疾病诊断中的作用。方法用ELISA法检测241例RA、106例SLE、29例SSc、6例MCTD、365例其他风湿病、240例非风湿病患者血清中抗hnRNPA2/RA33抗体的滴度,比较其在各组患者中的阳性率,并检测RA、SLE、SSc组抗hnRNPA2/RA33抗体阳性患者血清中ANA、ds-DNA、ENA抗体的阳性数。结果抗hnRNPA2/RA33抗体在RA患者中阳性率为18.7%,在其他各组患者中阳性率分别为SLE31.1%、SSc31.0%、MCTD16.7%、PM11.1%、DM11.1%、UCTD12.1%、反应性关节炎10.0%、成人Still’s病5.9%、SS4.0%、SpA3.5%、晶体性关节炎10.6%及非风湿病组3.8%,其中RA、SLE、SSc组阳性率明显高于非风湿病组(P<0.001),SLE组阳性率高于RA组(P=0.010)。RA组抗hnRNPA2/RA33抗体阳性患者血清中均未测出ds-DNA、RNP、SM抗体,而SLE、SSc组抗hnRNPA2/RA33抗体阳性患者血清中有不同程度表达。结论抗hnRNPA2/RA33抗体在多种风湿病中出现,有助于风湿病的诊断,但缺乏特异性,在临床鉴别诊断中需与其它自身抗体如ANA、ds-DNA、ENA等联合检测,以提高诊断的准确率。
Objective To detect serum anti-heterozygous nuclear ribonucleoprotein A2 (hnRNPA2) / rheumatoid arthritis (RA) 33 antibodies in patients with different rheumatic diseases and to explore its role in the diagnosis of rheumatic diseases. Methods The titer of anti-hnRNPA2 / RA33 antibody in sera of 241 patients with RA, 106 patients with SLE, 29 patients with SSc, 6 patients with MCTD, 365 patients with other rheumatism and 240 patients without rheumatism was detected by ELISA. The positive rates of ANA, ds-DNA and ENA in sera of patients with positive anti-hnRNPA2 / RA33 antibodies were detected in RA, SLE and SSc groups. Results The positive rate of anti-hnRNPA2 / RA33 antibody in RA patients was 18.7%. The positive rates of other anti-hnRNPA2 / RA33 antibodies were SLE31.1%, SSc31.0%, MCTD16.7%, PM11.1%, DM11.1% , UCSD12.1%, reactive arthritis 10.0%, adult Still’s disease 5.9%, SS4.0%, SpA3.5%, crystal arthritis 10.6% and non-rheumatic diseases group 3.8%, including RA, SLE, SSc group The positive rate of SLE group was significantly higher than that of non-rheumatic group (P <0.001). The positive rate of SLE group was higher than that of RA group (P = 0.010). Serum ds-DNA, RNP and SM antibodies were not detected in RA patients with anti-hnRNPA2 / RA33 antibody positive, while SLE and SSc patients expressed anti-hnRNPA2 / RA33 antibody positive serum in varying degrees. Conclusion Anti-hnRNPA2 / RA33 antibodies appear in a variety of rheumatic diseases, which is helpful for the diagnosis of rheumatism but lack of specificity. Combined with other autoantibodies such as ANA, ds-DNA, ENA and so on in clinical differential diagnosis, Improve diagnostic accuracy.