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类风湿因子(RF)存在于80%类风湿性关节炎(RA)病人中,美国风湿病协会将其作为类风湿病的诊断标准之一。血清中无 RF 的关节炎病人常被归类为血清阴性的脊椎关节炎,后者包括一组易与 RA 混淆的疾病。23～40%的 RA 病人血清中 RF 阴性,但近来证实即使 RF 阴性的患者亦会有循环免疫复合物。此类患者的预后似较血清阳性病人佳,且两者的临床表现也不同。对血清阴性患者的详细随访证实,部分可转为阳性,而另一些发展为牛皮癣性关节炎、Reiter病和其它非类风湿性疾病,尚有某些患者血清学试验始终保持阴性且不出现其它明确综合症。
Rheumatoid factor (RF) is present in 80% of rheumatoid arthritis (RA) patients and is used by the American College of Rheumatology as one of the diagnostic criteria for rheumatoid arthritis. Patients with non-RF arthritis in serum are often classified as seronegative spondylarthritis, which includes a group of diseases that are easily confused with RA. 23-40% of RA patients have RF-negative serum sera, but recently it has been demonstrated that circulating immune complexes are present even in patients with RF-negative disease. The prognosis of such patients is better than that of seropositive patients, and the clinical manifestations of the two are different. A detailed follow-up of seronegative patients confirmed that some may turn positive while others develop psoriatic arthritis, Reiter’s disease and other non-rheumatoid diseases, and some patients have serological tests that remain negative and do not show other Clear syndrome.