血清抗环瓜氨酸肽抗体等对湿热痹阻及寒湿痹阻型类风湿关节炎的诊断意义  

Diagnostic Significance of Anti-CCP,RF,GPI and AKA in Damp-heat and Cold-damp Bi-syndromes of TCM in Rheumatoid Arthritis

作　　者：王志中[1] 王勇[1] 张疆瑾[2] 张荣华[1] 李景怡[1] 柏干苹[1] 陈珏蓉[1] 马文杰[1] 方勇飞[1] 

机构地区：[1]中国人民解放军第三军医大学西南医院中西医结合科 [2]中国人民武装警察部队新疆生产建设兵团指挥部第七支队

出　　处：《中医杂志》2011年第20期1741-1744,共4页Journal of Traditional Chinese Medicine

基　　金：国家自然科学基金资助项目(30973827);重庆市卫生局中医药科研项目(2008-1-15)

摘　　要：目的探讨血清抗环瓜氨酸肽抗体(抗-CCP)、类风湿因子(RF)、葡萄糖6磷酸异构酶(GPI)及抗角蛋白抗体(AKA)在湿热痹阻型与寒湿痹阻型类风湿关节炎(RA)中的诊断意义。方法收集305例RA患者临床数据,寒湿痹阻型146例,湿热痹阻型159例,纳入抗-CCP、RF、GPI分析样本276例,AKA分析样本253例。进行28个关节疾病活动度评分[DAS28(4)],检测AKA、RF、抗-CCP、GPI水平,分析抗-CCP、RF、GPI及AKA在湿热痹阻与寒湿痹阻型之间的差异以及与DAS28(4)的相关性。结果抗-CCP、RF、GPI及AKA水平在湿热痹阻与寒湿痹阻型RA间差异无统计学意义(P>0.05);两证型患者之间疾病活动度差异有统计学意义(P<0.01);抗-CCP、RF、GPI分别与关节压痛数、关节肿胀数、晨僵时间、DAS28(4)、C反应蛋白(CRP)等疾病活动性指标呈显著正相关(P<0.01)。结论抗-CCP、RF、GPI及AKA不能作为湿热痹阻及寒湿痹阻型RA的客观化分型依据,抗-CCP、RF、GPI与疾病活动有一定的相关性。Objective To explore the clinical significance of serum anti-cyclic citrullinated peptide（anti-CCP） antibody,rheumatoid factor（RF）,glucose-6-phosphate isomerase（GPI）,and anti-keratin antibody（AKA） in diagnosing the dampheat and cold-damp Bi-syndromes of TCM in rheumatoid arthritis（RA）.Methods The clinical data and serum of 305 patients with RA were collected.The anti-CCP,RF,and GPI samples of 276 patients and the AKA samples of 253 patients were enrolled.There were 146 patients with cold-damp Bi-syndrome and 159 patients with damp-heat Bi-syndrome.The patients were assessed with disease activity scores [DAS28（4）].Level of AKA,RF,anti-CCP and GPI was determined,and difference of anti-CCP,RF,GPI and AKA between damp-heat syndrome and cold-damp syndrome as well as the correlation with DAS28（4） was analyzed.Results The levels of anti-CCP,RF,GPI,and AKA were not statistically different in the damp-heat and cold-damp Bi-syndromes of RA（P0.05）.There was statistical difference in the disease activity between the two groups（P0.01）.The anti-CCP,RF,and GPI were positively correlated with the number of tender joints,number of swelling joints,time of morning stiffness,DAS28（4）,and CRP respectively（P0.01）.Conclusion The anti-CCP,RF,GPI,and AKA cannot be taken as the objective indications of classifying the damp-heat and cold-damp Bi-syndromes of RA.The anti-CCP,RF,and GPI are correlated with the disease activity to a certain degree.

关 键 词：类风湿关节炎 湿热痹阻型 寒湿痹阻型 血清抗环瓜氨酸肽抗体 类风湿因子 葡萄糖6磷酸异构酶 抗角蛋白抗体 疾病活动度 

分 类 号：R259[医药卫生—中西医结合]