CAJ | 학술논문

目的探讨抗CCP抗体、AKA、抗RA33抗体、6-磷酸葡萄糖异构酶(GPI)、RF等RA特异性血清标志物在不同风湿性疾病中的阳性率及分布情况,明确其在RA诊疗中的应用价值及其在非RA患者中阳性的临床意义.方法对2011年1月至2013年12月本院门诊及住院5 847例接受5种血清标志物检测的患者临床资料、诊断、检查结果进行回顾性研究,计数资料比较应用x2检验.结果在5847例确诊风湿性疾病患者中RF、抗CCP抗体、抗RA33抗体、AKA、GPI的阳性率分别为:52.5％(3 069/5 847)、40.1％(2 344/5 847)、12.8％(748/5 847)、12.0％(701/5 847)、50.0％(2 923/5 847),其中RA组患者阳性率分别为:80.4％ (2 784/3 464)、66.1％(2 290/3 464)、16.1％(556/3 464)、20.0％ (694/3 464)、75.1％(2 602/3 464),显著高于其他疾病组(P＜0.01);非RA组患者阳性率分别为:12.0％(286/2 383)、2.2％(54/2 383)、8.0％(191/2 383)、0.4％(10/2 383)、13.6％(323/2 383).结论 RF、抗CCP抗体、抗RA33抗体、AKA、GPI对RA有重要的诊断价值,但是上述标志物也可出现在其他疾病中,因此在临床诊疗过程需综合分析,避免片面根据血清学检查结果导致误诊,除SS外,抗CCP抗体、抗RA33抗体、RF阳性可能与骨侵蚀相关.
목적 탐토항CCP항체、AKA、항RA33항체、6-린산포도당이구매(GPI)、RF등RA특이성혈청표지물재불동풍습성질병중적양성솔급분포정황,명학기재RA진료중적응용개치급기재비RA환자중양성적림상의의.방법 대2011년1월지2013년12월본원문진급주원5 847례접수5충혈청표지물검측적환자림상자료、진단、검사결과진행회고성연구,계수자료비교응용x2검험.결과 재5847례학진풍습성질병환자중RF、항CCP항체、항RA33항체、AKA、GPI적양성솔분별위:52.5％(3 069/5 847)、40.1％(2 344/5 847)、12.8％(748/5 847)、12.0％(701/5 847)、50.0％(2 923/5 847),기중RA조환자양성솔분별위:80.4％ (2 784/3 464)、66.1％(2 290/3 464)、16.1％(556/3 464)、20.0％ (694/3 464)、75.1％(2 602/3 464),현저고우기타질병조(P＜0.01);비RA조환자양성솔분별위:12.0％(286/2 383)、2.2％(54/2 383)、8.0％(191/2 383)、0.4％(10/2 383)、13.6％(323/2 383).결론 RF、항CCP항체、항RA33항체、AKA、GPI대RA유중요적진단개치,단시상술표지물야가출현재기타질병중,인차재림상진료과정수종합분석,피면편면근거혈청학검사결과도치오진,제SS외,항CCP항체、항RA33항체、RF양성가능여골침식상관.
Objective To explore the distribution of anti-cyclic citrullinated peptide (CCP) antibody,anti-keratin antibody (AKA),anti-RA33 antibody,glucose-6-phosphate isomerase (GPI),rheumatoid factors (RF) in rheumatic diseases,and to evaluate the association between these distributions and rheumatoid arthritis (RA) in order to clarify its application in the diagnosis of rheumatoid arthritis and its clinical significance in non-seral-positive RA patients.Methods Data were derived from outpatients and inpatients of the department of Integrated Traditional and Western Medicine of Southwest Hospital during January,2011 to December,2013.All patients were tested for these five serological markers.Chi-square test was used to analyze the numerical data.Results Among the 5 847 cases,the positive rates of RF,anti-CCP antibody,anti-RA33 antibody,AKA,GPI were 52.5％(3 069/5 847),40.1％(2 344/5 847),12.8％(748/5 847),12.0％(701/5 847),50.0％(2 923/5 847),respectively.The positive rates of the RA patient group [80.4％(2784/3 464),66.1％(2 290/3 464),16.1％(556/3 464),20.0％(694/3 464),75.1％(2 602/3 464)] were signi-ficantly higher than those of other groups (P＜0.01).The positive rates of the non-RA patients group were 12.0％ (286/2 383),2.2％ (54/2 383),8.0％ (191/2 383),0.4％ (10/2 383),13.6％ (323/2 383) respectively.Conclusion RF,anti-CCP antibody,anti-RA33 antibody,AKA,GPI are of great significance in the diagnosis of RA.However,these serological markers are also found in other diseases.In the clinical diagnosis and treatment process,we should analyze comprehensively the specific conditions of patients in order to avoid misdiagnosis.In addition to Sj(o)gren's syndrome,the anti-CCP antibodies,anti-RA33 antibodies,RF may be associated with bone erosion.