血清抗环瓜氨酸肽抗体及葡萄糖-6-磷酸异构酶水平在判断类风湿关节炎患者疾病活动程度中的意义  

Evaluation the level of serum anti-cyclic citrullinated peptide antibody and glucose-6-phosphate isomerase in judging the activity of rheumatoid arthritis

作　　者：李海波[1] 刘荣清[1] 季晨[1] 杨丽娟[1] 

机构地区：[1]宁夏医科大学总医院风湿免疫科,宁夏银川750004

出　　处：《宁夏医学杂志》2015年第9期785-787,共3页Ningxia Medical Journal

基　　金：宁夏科技攻关计划项目(201244)

摘　　要：目的探讨血清抗环瓜氨酸肽抗体(CCP)、葡萄糖-6-磷酸异构酶(G6PI)水平与类风湿关节炎(RA)疾病活动程度之间的关系。方法入组216例RA患者,按RA疾病活动评分(DAS28)不同分为不同疾病活动组,即缓解组(48例)、低度活动组(60例)、中度活动组(56例)、高度活动组(52例),以72例健康人为对照组。通过不同疾病活动度组间、RA患者治疗前及接受标准化治疗后的比较,分析抗CCP抗体、G6PI水平与RA疾病活动程度之间的关系。结果 G6PI的水平在不同疾病活动度组间存在差异,活动组明显高于缓解组,且G6PI的水平随着疾病活动度的升高而升高,高度活动组G6PI为(8.97±2.78)μg·m L-1,中度活动组(6.26±2.47)μg·m L-1,低度活动组(4.11±2.51)μg·m L-1,缓解组(2.90±1.72)μg·m L-1,4组间比较差异有统计学意义(P<0.05)。而抗CCP抗体水平在RA不同疾病活动组间差异无统计学意义(P>0.05)。G6PI水平与RA患者压痛关节数、肿胀关节数、ESR、CRP、DAS28之间呈正相关(相关系数r分别为0.351、0.392、0.345、0.436、0.369);抗CCP水平与上述指标之间无相关性(P>0.05)。168例RA接受标准化治疗,146例完成研究,其中67例RA经治疗后评分出现下降,79例无下降;治疗前G6PI为(5.72±2.71)μg·m L-1,治疗后为(3.96±2.18)μg·m L-1,治疗后低于治疗前(P<0.05);抗CCP抗体则没有出现这种变化。结论 G6PI水平能在一定程度上反映RA的疾病活动程度。Objective To evaluate anti- cyclic citrullinated peptide（ CCP） antibody and glucose- 6- phosphate isomerase（ G6PI） in judeging the activity of rheumatoid arthritis（ RA）. Methods Disease activity score in 28 joints（ DAS28） was used as a criterion to evaluate the degree of RA activity. 216 RA patients were divided into high activity group,moderate activity group,low activity group and remission group by DAS28 and all the groups accepted the same treatment. The correlation between the levels of serum CCP or G6 PI and the degree of RA activity was analyzed by comparison between the different groups,and also comparison between baseline and after the treatment. Results The level of G6 PI were different between the different groups,G6 PI of high activity group was significantly higher than the low activity group. The level of G6 PI was increasing with the increase of RA activity. The G6 PI serum level of high activity group was（ 8. 97 ± 2. 78） μg·mL^-1,moderate activity group was（ 6. 26 ± 2. 47） μg·mL^-1,low activity group was（ 4. 11 ± 2. 51）μg·mL^-1,remission group was（ 2. 90 ± 1. 72） μg·mL^-1（ comparison between different groups,P〈0. 05）. There were no significant changes of CCP levels in all groups. And the serum levels of G6 PI were positively related to the number of tender joints（ r = 0. 351,P〈0. 05）,the number of swollen joints（ r = 0. 392,P〈0. 05）,ESR（ r = 0. 345,P〈0. 05）,CRP（ r = 0. 436,P〈0. 05） and DAS28（ r =0. 369,P〈0. 05）. But there was no association between CCP levels and above indices. There were 67 patients with the decreased DAS28 points after the treatment and accompanied with a decreased levels of serum G6 PI from the baseline（ 5. 72 ± 2. 71） μg · mL^-1to（ 3. 96 ± 2. 18） μg·mL^-1. While,the level of CCP was not changed after treatment. Conclusion The level of serum G6 PI can reflect the degree of RA activity.

关 键 词：类风湿关节炎 血清抗环瓜氨酸肽 葡萄糖-6-磷酸异构酶 疾病活动评分 

分 类 号：R593.22[医药卫生—内科学]