类风湿关节炎患者CMV、B19和HCV抗体的检测及临床意义  

Detection and clinic significance of CMV,B19 and HCV in Chinese Rheumatoid Arthritis patients

作　　者：尹志华[1] 叶志中[1] 陈新鹏[1] 甘达强[1] 张春容[1] 

机构地区：[1]深圳市第四人民医院香蜜湖风湿病分院,广东医学院深圳风湿病研究所,深圳518040

出　　处：《中国免疫学杂志》2011年第4期365-367,共3页Chinese Journal of Immunology

基　　金：深圳医学重点学科建设资助项目(2005C10);深圳市科技局资助项目(200702012)

摘　　要：目的:检测巨细胞病毒(CMV)IgG和IgM抗体、细小病毒B19 IgG和IgM抗体及丙型肝炎病毒(HCV)抗体在中国南方类风湿关节炎(RA)患者外周血中的表达,探讨CMV、B19、HCV在RA中的作用。方法:采用酶联免疫吸附试验(ELISA)法检测CMV-IgG和CMV-IgM抗体,B19-IgG和B19-IgM抗体以及HCV抗体;CMV-IgM抗体阳性者利用实时定量PCR法检测外周血单个核细胞中的CMV载量;B19-IgM抗体阳性者利用实时定量PCR法检测血清中的B19载量。同时分析这些病毒抗体与RA患者的实验室活动指标如抗环瓜氨酸肽(CCP)抗体、类风湿因子(RF)、红细胞沉降率(ESR)的相关性。结果:70例RA患者中,69例为CMV-IgG抗体阳性(98.57%),7例CMV-IgM抗体阳性(10.00%),49例B19-IgG抗体阳性(70.00%),16例B19-IgM抗体阳性(22.86%),无一例HCV抗体阳性;92例健康对照者中91例CMV-IgG抗体阳性(98.91%),1例CMV-IgM抗体阳性(1.10%),42例B19-IgG抗体阳性(45.65%),19例B19-IgM抗体阳性(20.65%),仅1例HCV抗体阳性;RA患者CMV-IgM抗体阳性率明显高于对照组(P<0.05),CMV-IgM抗体阳性RA患者外周血单个核细胞未检测到CMV载量;RA患者B19-IgG抗体阳性率明显高于对照组(P<0.01),而两组间B19-IgM抗体阳性率无差别(P>0.05),B19-IgM抗体阳性RA患者血清中未检测到B19载量;CMV-IgM抗体阳性、B19-IgG抗体阳性与抗CCP抗体、RF、ESR等RA活动性指标不相关。结论:中国南方人群普遍感染CMV,但CMV重新激活与RA有关;B19感染在RA患者中有更高的流行率;HCV在中国南方人群感染率低。Objective：To explore the level of anti-cytomegalovirus（CMV）-IgG and IgM antibody,anti-human parvovirus B19-IgG and IgM antibody and anti-hepatitis C virus（HCV） antibody in rheumatoid arthritis（RA） patients.Methods：Seventy RA patients and ninety-two healthy individuals were detected.Antibodies to these viruses were determined by enzyme-linked immunosorbent assay.CMV and B19 virus loads were quantified by real-time PCR.The association between the existence of antibodies and some laboratorial indexes such as anti-cyclic citrullinated peptide（CCP） antibody,rheumatoid factor（RF） and erythrocyte sedimentation rate（ESR）in RA patients were analyzed.Results：Total of 70 RA patients,69 cases were anti-CMVIgG positive（98.57%）,7 anti-CMV-IgM positive（10.00%）;49 anti-B19-IgG positive（70.00%） and 16 anti-B19-IgM positive（22.86%）,nobody anti-HCV positive.Total of 92 healthy individuals,91 were anti-CMV-IgG positive（98.91%）,1 anti-CMV-IgM positive（1.10%）;42 anti-B19-IgG positive（45.65%）,19 antiB19-IgM positive（20.65%） and 1 anti-HCV positive.The prevalence of anti-CMV-IgM was higher in RA patients than in controls（P〈0.01）.CMV virus load was not detected in RA patients and control groups.The prevalence of anti-B19-IgG was higher in RA patients than in controls（P〈0.01）.While there was no difference for the prevalence of anti-B19-IgM.B19 virus load was not detected in RA patients and control.There was no association between these virus antibodies and anti-CCP antibody,RF and ESR.Conclusion：These results show that CMV infection in southern China is ubiquitous.Repeated or reactivated CMV infection may be associated with RA.RA patients have a high B19 infection rate but HCV infection in southern China is rare.

关 键 词：类风湿关节炎 巨细胞病毒 细小病毒B19 丙型肝炎病毒 

分 类 号：R593.22[医药卫生—内科学]