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目的:探讨I型胶原吡啶交联终肽等项目对于早期类风湿关节炎(RA)患者疾病诊断的预测价值。方法:2010年1月-2012年6月对我院风湿免疫科门诊及住院RA患者249例,采用ELISA定量检测血清ICTP、MMP-3、抗CCP抗体,采用免疫比浊法测定血清RF。结果:(1)ICTP、MMP-3、抗CCP抗体及RF在早期RA中的水平与对照组相比,差异均有统计学意义(P<0.01)。(2)早期RA组的ICTP、MMP-3的水平与CRP、关节肿胀指数、压痛指数、ESR、X现分期评分及疾病活动度积分(DAS28)评分成正相关。结论:对于新近发生的诊断不明的关节炎患者、症状不典型或症状典型RF阴性者可以联合检测这四种抗体,可降低RA的漏诊率。动态测定ICTP、抗CCP抗体、RF、MMP-3能更有效地及时监测RA的疾病进展。
Objective: To investigate the predictive value of type I collagen, such as pyridine cross-linked peptide, for diagnosis of disease in patients with early rheumatoid arthritis (RA). Methods: From January 2010 to June 2012, 249 RA patients were enrolled in the department of rheumatology and hospitalized in our hospital. Serum ICTP, MMP-3 and anti-CCP were detected by ELISA. Serum RF was measured by immunoturbidimetry. Results: (1) The levels of ICTP, MMP-3, anti-CCP antibody and RF in early RA were significantly different from those in control group (P <0.01). (2) The levels of ICTP and MMP-3 in early RA group were positively correlated with CRP, joint swelling index, tenderness index, ESR, X staging score and disease activity score (DAS28) score. CONCLUSIONS: In newly diagnosed patients with unidentified arthritis, atypical symptoms or typical RF-negative symptoms can be combined to detect these four antibodies and reduce the rate of missed diagnosis of RA. Dynamic determination of ICTP, anti-CCP antibody, RF, MMP-3 can more effectively monitor the progress of RA disease.