血清抗体与类风湿关节炎骨侵蚀及预后的关系分析  

Relationship Between Serum Antibodies and Bone Erosion and Prognosis in Rheumatoid Arthritis

作　　者：刘晓玲 金宇 Liu Xiaoling;Jin Yu(Department of Laboratory Medicine,The Second Affiliated Hospital of Chengdu Medical College·Nuclear Industry 416 Hospital,Chengdu 610051,China)

机构地区：[1]成都医学院第二附属医院·核工业四一六医院检验科,成都610051

出　　处：《成都医学院学报》2024年第4期610-613,共4页Journal of Chengdu Medical College

基　　金：四川省科技厅应用基础研究项目(No:2018JY0372);中国宝原投资有限公司同位素制品科研项目(No:CBYI202101)。

摘　　要：目的探讨血清抗环瓜氨酸肽(CCP)抗体、抗核抗体(ANA)、抗突变型瓜氨酸波形蛋白(MCV)抗体与类风湿关节炎(RA)骨侵蚀及预后的关系。方法采用回顾性分析,选取2020年4月至2023年4月在成都医学院第二附属医院·核工业四一六医院就诊的158例RA患者纳入RA组,同期80例健康体检者纳入对照组;RA组基于X线检查结果进一步分为骨侵蚀组(n=86)和非骨侵蚀组(n=72);所有RA组患者均接受标准化治疗,根据预后评估结果分为预后良好组(n=112)和预后不良组(n=33);比较RA组与对照组以及不同骨侵蚀情况、不同预后患者血清抗CCP抗体、ANA、抗MCV抗体水平,分析血清抗CCP抗体、ANA、抗MCV抗体水平与RA患者骨侵蚀及预后的关系。结果RA组血清抗CCP抗体、抗MCV抗体水平及ANA阳性率均高于对照组(P<0.05);骨侵蚀组血清抗CCP抗体、抗MCV抗体水平及ANA阳性率均高于非骨侵蚀组(P<0.05);预后不良组血清抗CCP抗体、抗MCV抗体水平及ANA阳性率均高于预后良好组(P<0.05);多因素Logistic回归分析显示,血清抗CCP抗体、ANA、抗MCV抗体水平均为RA患者不良预后的独立相关因素(P<0.05);受试者工作特征(ROC)曲线显示,血清抗CCP抗体、抗MCV抗体水平的ROC曲线下面积分别为0.893、0.777,联合预测ROC曲线下面积为0.949,二者预测RA患者不良预后的最佳截断值分别为102.94、424.61 IU/mL。结论血清抗CCP抗体、ANA、抗MCV抗体与RA患者骨侵蚀及预后密切相关,可作为患者不良预后的预测因子。Objective To explore the relationship between serum anti-cyclic citrullinated peptide(CCP)antibody,antinuclear antibody(ANA),anti-mutant citrulline vimentin(MCV)antibody levels and bone erosion and prognosis in rheumatoid arthritis(RA).Methods A retrospective analysis was conducted.A total of 158 RA patients in the Second Affiliated Hospital of Chengdu Medical College(also known as Nuclear Industry 416 Hospital)from April 2020 to April 2023 were included in the RA group,while 80 healthy individuals undergoing physical examination during the same period were included in the control group.The RA group was further divided into the bone erosion group(n=86)and the non-bone erosion group(n=72)based on X-ray examination results.All the RA patients received standardized treatment and were classified into the good prognosis group(n=112)and the poor prognosis group(n=33)based on the results of prognosis assessment.Serum levels of anti-CCP antibody,ANA and anti-MCV antibody were compared between the RA group and the control group and among patients with different bone erosion status and different prognosis status.And the relationships between serum anti-CCP antibody,ANA and anti-MCV antibody levels and bone erosion and prognosis in PA patients were analyzed.Results The serum anti-CCP antibody and anti-MCV antibody levels and ANA positive rate in the RA group were higher than those in the control group(P<0.05).The serum anti-CCP antibody and anti-MCV antibody levels and ANA positive rate in the bone erosion group were higher than those in the non-bone erosion group(P<0.05).The serum anti-CCP antibody and anti-MCV antibody levels and ANA positive rate in the poor prognosis group were higher than those in the good prognosis group(P<0.05).Multivariate Logistic regression analysis showed that serum anti-CCP antibody,ANA,and anti-MCV antibody were independent related factors of poor prognosis in RA patients(P<0.05).ROC curve suggested that the AUCs of serum anti-CCP antibody and anti-MCV antibody for the prediction of poor progno

关 键 词：类风湿关节炎 抗环瓜氨酸肽抗体 抗核抗体 骨侵蚀 预后 

分 类 号：R593.22[医药卫生—内科学]