环瓜氨酸肽抗体及调节性T细胞水平与类风湿关节炎骨关节侵蚀的关系研究  

Correlations of articular erosion with cyclic citrullinated peptide antibody and regulatory T cells in rheumatoid arthritis

作　　者：向登[1] 林炎水[1] 贺军[1] 刘金望[1] 余华[1] 赵文[1] 

机构地区：[1]成都医学院第一附属医院关节外科,610500

出　　处：《中国医药》2016年第9期1342-1345,共4页China Medicine

摘　　要：目的探讨环瓜氨酸肽（CCP）抗体及CD4＋CD25＋调节性T细胞（Treg细胞）水平与类风湿关节炎（RA）骨关节侵蚀之间的关系。方法选取2014年1月至2015年1月成都医学院第一附属医院收治的120例RA患者作为观察组，选取同时期自愿参与研究的40名健康人作为对照组，测定2组的CCP抗体及CD4CD；Treg细胞表达水平，并采用X线片评价骨关节侵蚀程度。结果观察组CCP抗体阳性率明显高于对照组，差异有统计学意义[66．7％（80／120）比0．0％（0／40）,X2=17．78，P〈0．01]；CD4＋CD25＋Treg细胞水平明显低于对照组，差异有统计学意义[（3．4±1．8）％比（4．2±2．1）％，t=2．46，19〈0．05]。CCP抗体诊断RA的敏感度为66．7％，特异度100．0％。CCP阳性组（80例）骨关节侵蚀评分及骨关节侵蚀率明显高于CCP阴性组（40例），差异有统计学意义[（7．9±3．4）分比（3．4±2．3）分、72．5％（58／80）比17．5％（7／40），P〈0．05]。CCP抗体与骨关节侵蚀率呈高度正相关（r=0．85，P〈0．01）；CD4＋CD25＋Treg细胞水平与骨关节侵蚀率无相关性（r=-0．13，P〉0．05）。结论CCP抗体与RA患者骨关节侵蚀率呈正相关，但CD4＋CD25＋Treg细胞水平与骨关节侵蚀率无关。CCP抗体诊断RA敏感度和特异度较好，可作为临床RA早期诊断和预测骨关节侵蚀程度的指标。Objective To investigate the correlations between articular erosion with cyclic citrullinated peptide （CCP） antibody levels and associated egulatory T cells （Treg cells） in patients with rheumatoid arthritis （RA）. Methods Totally 120 RA patients （observation group ） and 40 healthy people （control group ） from January 2014 to January 2015 were enrolled. The levels of CCP antibody and CD4＋CD25＋ Treg cells were measured and the degree of bone erosion were evaluated by X-ray. Results The positive rate of CCP antibody in observation group was significantly higher than that in observation group [66. 7% （80/120） vs 0. 0% （0/40） ] （X2 = 17.78, P 〈0. 01 ） ; the level of CD4＋CD25＋ Treg cells in observation group was significantly lower than that in control group [ （3.4± 1.8） % vs （4. 2 ± 2. 1 ） % ] （ t = 2. 46, P 〈 0. 05 ）. The sensitivity and specificity of CCP antibody in diagnosing RA was 66. 7% and 100. 0%. The articular erosion score and rate of articular erosion in patients with positive CCP （80 cases） were significantly higher than those in patients with negative CCP （40 cases） [ （7.9 ± 3.4） scores vs （ 3.4 ±2. 3 ） scores, 72. 5% （58/80） vs 17.5% （7/40） ] （ P 〈 0. 05 ）. Level of CCP antibody and specificity of CCP antibody is good in diagnosing RA, and can be used as a predictive indicator of articular erosion degree.

关 键 词：类风湿关节炎 瓜氨酸抗体 调节性T细胞 骨关节侵蚀 

分 类 号：R593.2[医药卫生—内科学]