【摘要】 目的:探讨血清中葡萄糖-6-磷酸异构酶(GPI)抗原检测对类风湿关节炎(RA)的诊断意义。方法:用酶联免疫吸附试验(ELISA)双抗体夹心法检测60例RA患者,26例其他风湿性疾病患者和100例健康人群中血清GPI抗原的浓度,并检测类风湿因子(RF)、抗环瓜氨酸肽(CCP)抗体、抗角蛋白抗体(AKA),RA患者还检测了C反应蛋白(CRP)和血沉(ESR)。结果:RA组的GPI浓度明显高于其他风湿性疾病组及健康对照组,且GPI水平在RA活动组与非活动组差异亦存在统计学意义(P<0.05);当GPI为0.49μg/mL时,其敏感度为73.7%,特异度为92.3%;GPI与RF有显著相关性(P<0.05),而与其他指标CRP、ESR无相关性(P>0.05);GPI和抗CCP抗体对RA诊断的敏感度和特异度无明显差异。结论:GPI、抗CCP抗体、AKA与RF联合检测,对类风湿因子阴性患者在诊断上可起到互补作用,GPI对RA的诊断及活动性判断具有广泛的临床应用及研究前景。更多还原

【Abstract】 Objective:Evaluate the role of serum glucose-6 phosphate isomerase(GPI) as a disease related antigen in diagnosing rheumatoid arthritis(RA).Methods: We used Enzyme-Linked ImmunoSorbent Assay(ELISA)to exam serum GPI level from 60 rheumatoid arthritis patients,26 other rheumatologic patients and 100 healthy controls;we also tested the rheumatoid factor(RF),anti-Cyclic Citrullinated Peptide(CCP) antibody and anti-keratin antibody(AKA).In the rheumatoid arthritis patient group,C-reative protein(CRP) and erythrocyte sedimentation rate(ESR) level were also tested.Results: RA group′s GPI concentration was significantly higher as compared the other rheumatologic disease group and the health controls,and there was a significant difference between the active phase and inactive phase in GPI level(P<0.05);At a GPI concentration of 0.49 μg/ml,the sensitivity of test reached 73.7% and the specificity 92.3%.GPI was shown to be significantly related to rheumatoid arthritis(P<0.05),while other factors such as CRP,ESR were not(P>0.05).There was no obvious difference between GPI and anti CCP antibody in terms of sensitivity and specificity for diagnosis of RA.Conclusion: Combining GPI,RF,AKA and anti CCP antibody tests seemed useful to confirm rheumatoid arthritis patient who are RF negative.GPI holds great promise as a diagnosis tool for RA and its activity,which warrants further investigation.更多还原