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目的探讨葡萄糖-6-磷酸异构酶(GPI)在类风湿关节炎(RA)诊断及与其他自身免疫性疾病鉴别诊断中的价值,并对GPI在RA中的致病机理进行初步分析。方法检测对象为51例RA组、40例健康对照组和46例其他自身免疫性疾病对照组,血清的GPI采用双抗体夹心酶联免疫吸附测定(ELISA)、类风湿因子(RF)和补体C3、C4浓度均采用免疫比浊法,对各组间检测结果进行统计分析。结果RA组的GPI浓度值和阳性率都显著高于其他自身免疫疾病对照组和健康对照组(P<0.01),且RA活动组GPI浓度值和阳性率显著高于RA非活动组(P<0.01);在GPI阳性的RA患者中,C3浓度升高,而C4不升高。结论GPI在RA中的检测意义要大于其他自身免疫性疾病,且它的升高程度与关节炎的活动性有关,GPI和RF联合检测对RA的鉴别诊断具有较高价值;GPI可通过替代途径激活补体系统,损伤关节表面,导致RA的发生。
Objective To investigate the value of glucose-6-phosphate isomerase (GPI) in the differential diagnosis of rheumatoid arthritis (RA) and other autoimmune diseases, and to analyze the pathogenesis of GPI in RA. Methods The subjects were 51 RA patients, 40 healthy controls and 46 other autoimmune diseases control groups. Serum GPI levels were measured by ELISA, rheumatoid factor (RF) and complement C3 , C4 concentrations were used immune turbidimetry, the results of the test between groups for statistical analysis. Results The GPI concentration and positive rate in RA group were significantly higher than those in other autoimmune diseases control group and healthy control group (P <0.01), and the GPI concentration and positive rate in RA group were significantly higher than those in RA non-active group (P < 0.01). In patients with GPI-positive RA, C3 concentration increased while C4 did not increase. Conclusion The detection of GPI in RA is more important than other autoimmune diseases, and its elevation is related to the activity of arthritis. The combined detection of GPI and RF has high value in the differential diagnosis of RA. Activate the complement system, damage the articular surface, leading to the occurrence of RA.