医药学论文：抗Ⅱ型胶原抗体的检测及其在类风湿关节炎中的意义[1]

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关键字：患者 水平 血清 天然 阳性 抗体 检测 阴性 变性 抗体阳性
　　【摘　要】　目的　了解抗Ⅱ型胶原抗体在类风湿关节炎(RA)中的临床意义。方法　以改进的酶联免疫吸附法(ELISA)检测179例RA患者和171例其他风湿病患者的血清IgG型抗天然及抗变性Ⅱ型胶原抗体水平。结果　RA患者抗天然和抗变性Ⅱ型胶原抗体阳性率各为22.3%和36.9%，早期RA患者各为30.0%和36.7%。其他风湿病患者中各为3.5%和31.6%，健康人二者均为2.5%。抗天然Ⅱ型胶原抗体阳性RA患者类风湿因子检出率、患者对病情活动性评价高于阴性组(P0.05)。抗变性Ⅱ型胶原抗体和抗天然Ⅱ型胶原抗体同时阳性RA患者的CRP平均水平较高。结论　抗天然Ⅱ型胶原抗体可以作为RA的一个辅助诊断指标。抗天然与抗变性Ⅱ型胶原抗体的检测有助于判断RA病情活动性。

　　Anti-type Ⅱ collagen antibodies in rheumatoid arthritis

　　【Abstract】　Objective　To investigate the clinical significance of anti-type-Ⅱ-collagens antibody in rheumatoid arthritis (RA).Method　Serum IgG antibodies to native and denatured type Ⅱ collagens (anti-nc Ⅱ and anti-dc Ⅱ) were detected in 179 patients with RA by an improved enzyme linked immunosorbent assay (ELISA),and their clinical significance was analysed with corresponding clinical materials.Results　In RA,the positive rates of anti-nc Ⅱ and anti-dc Ⅱ were 22.3% and 36.9%;in early RA were 30.0% and 36.7%,respectively.In other rheumatic diseases the positive rates were 3.5% and 31.6%,respectively and were both 2.5% in healthy controls.Anti-nc Ⅱ positive RA showed higher prevalence rate of RF and higher scores of patient′s global assessment of disease activity (P 0.05).The presence of anti-nc Ⅱ and anti-dc Ⅱ concomitantly was associated with high CRP level in RA patients.Conclusion　Anti-nc Ⅱ could serve as a supplemental parameter in diagnosing RA and together with anti-dc Ⅱ may help evaluate the disease activity.

　　【Key words】　Rheumatoid arthritis;　Anti-type Ⅱ collagen antibody;　Enzyme-linked immunosorbent assay;　C-reactive protein

　　抗Ⅱ型胶原抗体(antibodies to type Ⅱ collagen)与类风湿关节炎(RA)病情活动性、严重性的关系目前仍有争论。本研究参照Fujii等［1］提出的实验条件检测179例RA患者、171例其他风湿病和118名正常人血清的抗Ⅱ型胶原抗体，探讨其在RA中的临床意义。结果报告如下。

　　1　资料与方法

　　1.1　一般资料

　　1.1.1　病人组：为1994年9月至1999年3月在汕头大学医学院第一附属医院风湿科住院、门诊、随访的RA患者，共179例，全部符合1987年美国风湿病协会(ARA)的RA分类标准［2］。其中男性53例，女性126例，年龄17～76岁，平均46.3岁。其中病程1年之内，X线未出现明显骨质破坏者(以下简称早期病例)30例医药学论文