血清及关节液GPI抗原测定在早期类风湿关节炎诊断中的意义  

Diagnosis Significance of Serum and Synovial Fluid GPI Antigen Detection in Early Rheumatoid Arthritis

作　　者：王梦涛 刘丹 曹团平 巩义 王利 陈庆平 

机构地区：[1]西安市第五医院检验科,西安710082

出　　处：《现代检验医学杂志》2013年第4期17-19,共3页Journal of Modern Laboratory Medicine

基　　金：基金项目：陕西省卫生厅2012D25;2010年西安市科技局项目SF1020（5）.

摘　　要：目的 探讨血清和关节液中葡萄糖-6-磷酸异构酶（glucose-6-phosphate isomerase,GPI）抗原升高在早期类风湿关节炎（early rheumatoid arthritis,eRA）患者诊断中的意义.方法 应用酶联免疫吸附试验（ELISA）检测受检者血清中GPI抗原浓度,其中RA患者65例、非RA患者55例、健康体检者50例,并检测60例患者（RA组32例,非RA组28例）关节液中GPI浓度;用速率散射比浊法检测血清类风湿因子（RF）浓度.结果 RA组血清中GPI浓度为1.26±0.53 μg/ml,非RA组为0.13±0.08 μg/ml,对照组为0.08±0.05 μg/ml.RA组血清中GPI浓度显著高于非RA组（t=12.47,P＜0.01及对照组（t=11.05,P＜0.05）,差异具有统计学意义;三组血清GPI异常率分别为：RA组75.38%,非RA组3.63%,正常对照组 0,RA组血清GPI异常率明显高于其他两组,差异具有显著统计学意义（χ2=87.57,P＜0.01）.RA组关节液中GPI浓度（1.15±0.81 μg/ml）显著高于非RA组（0.09±0.13 μg/ml ）（t=13.71,P＜0.05）;RA组关节液GPI异常率（71.88%）明显高于非RA组（3.57%）,两组间差异具有统计学显著性意义（χ2=29.02,P＜0.01）.RF联合血清GPI检测对早期RA诊断的敏感度为92.31%,特异度为94.29%.结论 RA患者血清及关节液中GPI显著升高,可作为eRA诊断指标之一,GPI与RF联合检测对eRA诊断有很高的敏感度和特异度.Objective To investigate the diagnosis significance of glucose-6-phosphate isomerase （GPI） antigen increasing in the serum and synovial fluid of patients with early rheumatoid arthritis （eRA）. Methods The concentration of serum GPI in 65 patients with RA,55 Non-rheumatoid arthritis patients（Non-RA） and 50 normal control and the synovial fluid GPI con- centration in 60 patients（32 in RA,28 in Non-RA） weie assayed by ELISA. RF was determined by rate nephelometry. Re- suits Serum GPI concentration in RA group was 1.26±0.53 μg/ml,in Non-RA group was 0.13±0. 08 μg/ml,in normal control group was 0. 08±0.05 μg/ml. GPI concentration in serum of RA group was significantly higher than that of Non-RA group （t=12.47,P〈0.01） and normal control group （t=11.05 ,P〈0.05） and the difference was statistically significant. The abnormality rate of serum GPI in three groups were respectively; RA group 75.38%, Non-RA group 3.63%, normal control group 0. The abnormality rate of serum GPI in RA group was significantly higher than that in other two groups,and the difference was very statistics meaning （x2 = 87. 57, P^0. 01）. The concentration of GPI in the synovial fluid of RA group （1.15±0.81 μg/ml） was significantly higher than that of Non-RA group（0.09±0.13 μg/ml）（t= 13.71 ,P〈0. 05）. The abnormality rate of synovial fluid GPI in RA group （71.88%） was significantly higher than that in NomRA group （3.57%）, the difference between the two groups was statistically significant （x2 = 29.02, P〈0.01）. The sensitivity of diag- nosing eRA with detection of RF and GPI in serum was 92.31%,the specificity of that was 94. 55%. Conclusion The GPI that abnormally increases in serum and synovial fluidt in RA patients could be a new marker for diagnosing eRA. The com- bined detection of GPI and RF in the diagnosis of eRA has high sensitivity and specificity.

关 键 词：葡萄糖-6-磷酸异构酶抗原 早期类风湿关节炎 诊断 

分 类 号：R593.22[医药卫生—内科学] R392.11[医药卫生—临床医学]