CAJ | 학술논문

目的检测类风湿关节炎(RA)患者血清抗纤维蛋白原(FIB) β67-77肽(FIB β67-77)及抗瓜氨酸化纤维蛋白原(C-FIB) β67-77肽(C-FIB β67-77)抗体水平,评价IgG、IgA、IgM型抗C-FIB β67-77抗体在RA诊断中的价值.方法酶联免疫吸附法(ELISA)检测227例RA患者、188例疾病对照和100名健康对照组血清抗C-FIB β67-77抗体的水平,分析其在RA诊断中的意义.结果 (1)RA患者IgG、IgA、IgM型抗C-FIB β67-77抗体滴度均值(分别为104.8、69.6和78.2)均高于其他对照组(P＜0.01).而各组血清中抗FIB β67-77抗体的滴度差异无统计学意义.(2)抗C-FIBβ67-77抗体IgG型、IgA型和IgM型在RA中诊断的敏感性分别为50.7％、48.5％和55.1％；特异性分别为94.8％、92.7％和92.4％.联合检测3个亚型敏感性为87.7％,特异性可达78.5％.(3)抗C-FIB β67-77抗体IgG型、IgM型和IgA型在IgM-RF阴性患者中的阳性率分别是52.9％、39.2％和54.9％；抗角蛋白抗体(AKA)、抗核周因子(APF)和抗环瓜氨酸肽(CCP)抗体3种抗体均阴性的患者中阳性率分别为48.5％、53.1％和37.5％.结论抗C-FIBβ67-77抗体在RA诊断中具有较好的敏感性和特异性,尤其对IgM-RF、AKA、APF及抗CCP抗体阴性RA的诊断具有参考意义.
목적 검측류풍습관절염(RA)환자혈청항섬유단백원(FIB) β67-77태(FIB β67-77)급항과안산화섬유단백원(C-FIB) β67-77태(C-FIB β67-77)항체수평,평개IgG、IgA、IgM형항C-FIB β67-77항체재RA진단중적개치.방법 매련면역흡부법(ELISA)검측227례RA환자、188례질병대조화100명건강대조조혈청항C-FIB β67-77항체적수평,분석기재RA진단중적의의.결과 (1)RA환자IgG、IgA、IgM형항C-FIB β67-77항체적도균치(분별위104.8、69.6화78.2)균고우기타대조조(P＜0.01).이각조혈청중항FIB β67-77항체적적도차이무통계학의의.(2)항C-FIBβ67-77항체IgG형、IgA형화IgM형재RA중진단적민감성분별위50.7％、48.5％화55.1％；특이성분별위94.8％、92.7％화92.4％.연합검측3개아형민감성위87.7％,특이성가체78.5％.(3)항C-FIB β67-77항체IgG형、IgM형화IgA형재IgM-RF음성환자중적양성솔분별시52.9％、39.2％화54.9％；항각단백항체(AKA)、항핵주인자(APF)화항배과안산태(CCP)항체3충항체균음성적환자중양성솔분별위48.5％、53.1％화37.5％.결론 항C-FIBβ67-77항체재RA진단중구유교호적민감성화특이성,우기대IgM-RF、AKA、APF급항CCP항체음성RA적진단구유삼고의의.
ObjectiveTo detect the antibodies against human fibrinogen (FIB)β67-77 peptide and citrullinated human FIB β67-77 peptide in rheumatoid arthritis (RA) and examine their diagnostic values in RA.Methods The antibodies against FIB β67-77 peptide and citrullinated FIB β67-77 peptide were detected by enzyme-linked immunosorbent assay (ELISA) in 227 RA patients,188 other connective tissue disease and 100 healthy controls.And their clinical applications were analyzed in the diagnosis of RA.Results (1)The prevalence and titer of IgG,IgA and IgM isotypes of anti-citrullinated FIB β67-77 peptide antibodies in RA were significantly higher than those with other rheumatic diseases and healthy individuals.However,the prevalence of anti-FIB β67-77 peptide antibodies in RA patients was similar to those with other rheumatic diseases and healthy individuals (P ＞ 0.05).(2) The diagnostic sensitivity of IgG,IgA and IgM of anti-FIB β67-77 peptide antibodies for RA were 50.7％,48.5％ and 55.1％ and the specificity 94.8％,92.7％ and 92.4％ respectively.The sensitivity of combined detection of 3 subtypes was up to 87.7％ and the specificity 78.5％.(3) No significant correlations existed between anti-citrullinated FIB β67-77 peptide antibodies,RF,anti-CCP antibody,AKA and APF respectively.Moreover,the seropositive rates of IgG,IgM and IgA of anti-citrullinated FIB β67-77 peptide were 52.9％,39.2％ and 54.9％ in IgM-RF negative patients Versus 48.5％,53.1％ and 37.5％ in anti-CCP antibody,AKA and APF negative patients respectively.Conclusion IgG,IgM and IgA antibodies to citrullinated FIB β67-77 peptide are sensitive and specific in the diagnosis of RA.And the test of anti-citrullinated FIB β67-77 peptide antibodies is especially useful in diagnosing RA with other negative autoantibodies.