血清抗氨甲酰化蛋白自身抗体对类风湿关节炎诊断及骨质损伤评估的价值  

Evaluation of Serum Anti-CarP Antibody in Early Diagnosis of Rheumatoid Arthritis and Prediction of Bone Damage

作　　者：吴钢 谭云芝 段雨函 WU Gang;TAN Yun-zhi;DUAN Yu-han(Central Hospital of Tujia and Miao Autonomous Prefecture,Enshi Prefecture,Hubei Enshi,445000)

机构地区：[1]湖北省恩施州土家族苗族自治州中心医院输血科,湖北恩施445000 [2]湖北省恩施州土家族苗族自治州中心医院肾病风湿内科,湖北恩施445000 [3]湖北省恩施州土家族苗族自治州中心医院临床检验中心,湖北恩施445000

出　　处：《医学临床研究》2019年第12期2292-2294,2298,共4页Journal of Clinical Research

摘　　要：【目的】探究血清抗氨甲酰蛋白(CarP)抗体在早期诊断类风湿性关节炎(RA)及预测骨质损伤中的价值。【方法】选择2015年6月至2018年6月本院收治的100例RA患者(观察组),根据DAS28评分标准分为稳定期和活动期。选择同期有无其他免疫系统疾病作为对照组以及健康组,检测和比较每组患者血清抗CarP抗体、C反应蛋白(CPR)、抗环瓜氨酸肽(CCP)、类风湿因子(RF)、基质金属蛋白酶3(MMP3)水平以及DAS28评分,并分析RA患者血清抗CarP抗体与血清因子、DAS28评分以及不同程度骨损伤的相关性。【结果】观察组患者血清抗CarP抗体表达水平及阳性率均显著高于对照组和健康组,差异有统计学意义(P<0.05)。RA活动期组患者血清抗CarP抗体与CRP、RF、CCP、MMP3的水平和DAS28评分均显著高于RA稳定期组患者,差异均有统计学意义(P<0.05)。不同级别骨损伤RA患者血清抗CarP抗体与CRP、RF、CCP、MMP3水平存在差异,其中Ⅱ期显著高于Ⅰ期、0期,差异有显著性(P<0.05)。RA患者的血清抗CarP抗体与CRP、RF、CCP、MMP3、DAS28评分和骨损伤分期均呈现显著正相关关系(P<0.05)。【结论】抗CarP抗体在RA患者血清中高表达,并且抗CarP抗体水平随着RA活动性增加和骨质损伤的加重而升高。【Objective】To explore the value of serum anti-carbamyl protein(anti-CarP)antibody in early diagnosis of rheumatoid arthritis(RA)and prediction of bone damage.【Methods】A total of 100 patients with RA admitted to our hospital from June 2015 to June 2018 were selected as the observation group whose RA disease activity and bone damage were sub-divided into the active and stable status according to the DAS28 score and X-ray film image.Healthy volunteers in the same period were selected as the control group.Levels of anti-CarP antibody,C-reactive protein(CPR),anti-cyclic citrullinated peptide(CCP),rheumatoid factor(RF)and matrix metalloproteinase 3(MMP3)plus DAS28 score were measured and compared.The correlations of serum anti-CarP antibody with different serum factors,DAS score and degrees of bone damage were analyzed.【Results】The expression level and positive rate of serum anti-CarP antibody in the observation group were significantly higher than those in the control group(P<0.05).Levels of serum anti-CarP antibody,CRP,RF,CCP and MMP3 plus DAS28 score in patients with active RA were significantly higher than those in patients with stable RA(P<0.05).The results showed that there were significant differences in serum levels of anti-CarP antibody,CRP,RF,CCP and MMP3 in RA patients with different degrees of bone injury(P<0.05).Of which,values of stageⅡRA patients were significantly higher than those of RA patients in stageⅠand stage 0(P<0.05);Values of stage I RA patients were significantly higher than those of RA patients in phase 0(P<0.05).The serum anti-CarP antibody of RA patients showed significant positive correlation with CRP,RF,CCP,MMP3,DAS28 scores and bone injury stages(P<0.05).【Conclusion】Anti-CarP antibodies are highly expressed in the serum of RA patients,and anti-CarP antibody levels increase with RA activity and bone damage.

关 键 词：关节炎 类风湿/诊断 蛋白质类 

分 类 号：R593.22[医药卫生—内科学]