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类风湿因子分型检测在类风湿关节炎中的综合应用评价 预览

Comprehensive evaluation of rheumatoid factor type detection in rheumatoid arthritis
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摘要 目的:探讨类风湿因子分型检测在类风湿关节炎(RA)中的综合临床应用价值。方法:选取2016年1月至2018年3月我院住院患者174例,分为RA活动期组、RA非活动期组和OA组。采用间接免疫荧光法检测AKA,间接酶联免疫吸附法检测Anti-CCP、RA33、RF-IgA、RF-IgG、RF-IgM,免疫比浊法检测ASO、RF、CRP、C3、C4、IgA、IgG、IgM,全自动血沉分析仪检测ESR。结果:①AKA、Anti-CCP、RA33、RF-IgA、RF-IgG、RF-IgM的灵敏度分别为10.77%、66.92%、13.85%、52.31%、63.08%、66.15%,特异度分别为97.78%、86.90%、84.78%、76.09%、86.83%、82.95%,RF-IgA、RF-IgG、RF-IgM三项指标联合诊断灵敏度为71.54%,六项指标联合诊断灵敏度为83.08%。②Anti-CCP、RF-IgA、RF-IgG、RF-IgM、ESR、RF、IgA水平在RA非活动期组、RA活动期组和OA组间有差异(P<0.05),而RA33、CRP、ASO、C3、C4、IgG、IgM水平在三组间无差异(P>0.05)。③RA活动期组中,RF-IgA、RF-IgG、RF-IgM与Anti-CCP、CRP、RF、IgM呈正相关关系(P<0.05),RF-IgG、RF-IgM与ESR呈正相关关系(P<0.05),RF-IgM与C4呈正相关关系(P<0.05);RA非活动期组中,RF-IgG、RF-IgM与RF呈正相关关系(P<0.05)。④RF-IgA、RF-IgG、RF-IgM表达水平在关节受累个数<5个组低于其在关节受累个数5~10个组和关节受累个数>10个组(P<0.05)。⑤多关节受累组的RF分型三项同时升高比率高于少关节受累组,RF分型三项均未升高的比率低于少关节受累组(P<0.05)。结论:RF分型联合其他指标检测能够提高RA的检出率,RF分型与RA活动度、关节受累个数等一些经典指标相关,且RF分型同时升高时病情更重,因此RF分型是诊断RA较优秀的新指标。 Objective: To explore the clinical application value of rheumatoid factor typing in rheumatoid arthritis. Methods: A total of 174 inpatients in our hospital from January 2016 to March 2018 were selected and divided into RA active group,RA non-active group and OA group.AKA was detected by indirect immunofluorescence assay and anti-CCP,RA33,RF-IgA,RF-IgG and RF-IgM were detected by indirect enzyme-linked immunosorbent assay.ASO,RF,CRP,C3,C4,IgA,IgG,and IgM were detected by immunoturbidimetry,and ESR was measured by an automated blood sedimentation analyzer. Results:①The sensitivities of AKA,Anti-CCP,RA33,RF-IgA,RF-IgG and RF-IgM were 10.77%,66.92%,13.85%,52.31%,63.08% and 66.15%,respectively.The specificities were 97.78%,86.90%,84.78%,76.09%,86.83%,82.95%,respectively,the combined diagnostic sensitivity of RF-IgA,RF-IgG,RF-IgM was 71.54%,and the combined sensitivity of six indicators was 83.08%.②The levels of Anti-CCP,RF-IgA,RF-IgG,RF-IgM,ESR,RF and IgA were different in RA inactive group,RA active group and OA group( P <0.05).The positive rate of AKA,RA33,CRP,ASO,C3,C4,IgG,IgM levels did not differ among the three groups( P >0.05).③During the active period of RA,RF-IgA,RF-IgG,RF-IgM were positively associated with Anti-CCP,CRP,RF,IgM( P <0.05).RF-IgG,RF-IgM were positively associated with ESR( P <0.05).RF-IgM was positively associated with C4( P <0.05).During the non-active period of RA,RF-IgG,RF-IgM were positively associated with RF( P <0.05).④RF-IgA,RF-IgG and RF-IgM levels in the joint involvement <5 groups were lower than the number of joint involvement 5-10 groups and the number of joint involvement >10 groups( P <0.05 ).⑤The rate of simultaneous rheumatoid factor typing increase in the group with less joint involvement was lower than that in the group with multiple joints( P <0.05),and the rate of no rheumatoid factor typing increase in the group with less joint involvement was significantly higher than that in the group with multiple joints( P <0.05). Conclusion: RF typing combined with other ind
作者 唐笛娇 孙贵凤 罗鹏 邹麟 TANG Di-Jiao;SUN Gui-Feng;LUO Peng;ZOU Lin(Department of Laboratory Medicine,the First Affiliated Hospital of Chongqing Medical University,Chongqing 400016,China)
出处 《中国免疫学杂志》 CAS CSCD 北大核心 2019年第16期1999-2004,2031共7页 Chinese Journal of Immunology
基金 国家自然科学基金委员会资助项目(No.81501834)。
关键词 类风湿关节炎 类风湿因子分型 抗环瓜氨酸多肽抗体 Rheumatoid arthritis Rheumatoid factor typing Anti-cyclic citrullin polypeptide antibody
作者简介 唐笛娇,女,硕士,检验技师,主要从事免疫学及血液病方面的研究,E-mail:dodo223@qq.com;通讯作者及指导教师:邹麟,女,主管技师,主要从事自身抗体及感染性免疫相关研究,E-mail:972857652@qq.com。
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