【摘要】 目的　了解抗Sa抗体的临床意义。方法　从新鲜人胎盘中提取Sa抗原 ,应用免疫印迹法检测类风湿关节炎 (RA)及其他风湿病患者血清的抗Sa抗体 ,结合临床资料进行分析。结果　 192例RA中抗Sa抗体阳性 6 5例 ,对RA诊断的敏感性为 33 9% ,特异性为 96 9%。其中同时出现相对分子量为 5 0 0 0 0、5 5 0 0 0两条带的 15例 (2 3 1% ) ,其医师和患者对病情活动性的评价、患者对关节痛的评价及C反应蛋白 (CRP)增高与单独出现 5 0 0 0 0条带者相比 ,均显著增高。 31例早期RA抗Sa抗体阳性率为 32 3% ,9例经随访确诊RA者 4例抗Sa抗体阳性 ;6 3例RF阴性RA中抗Sa抗体阳性率为 2 7%。抗Sa抗体阳性组以小关节起病为主 ,且RF滴度明显较阴性组高。结论　抗Sa抗体有助于早期RA和RF阴性RA诊断 ,同时出现 5 0 0 0 0、5 5 0 0 0两条带可能与病情活动有关。更多还原

【Abstract】 Objective To investigate the significance of anti Sa antibody in rheumatoid arthritis (RA).Methods Sa antigen was extracted from human fresh placenta.Anti Sa antibody was detected at the sera titer of 1∶40 using Western blotting,and its clinical significance was investigated with the corresponding clinical materials.Results Anti Sa antibody was found in 33 9% (65/192) of RA patients.Its specificity for RA was 96 9%.The scores of patient′s and physician′s global assessment of disease activity,patient′s assessment of pain and level of C reaction protein were higher in anti Sa antibody existed with 50 000 and 55 000 bands than that in anti Sa antibody with single 50 000 band.Anti Sa antibody was detected in 32 3% (10/31) of early RA patients and in 27% (17/63) of RF negative RA patients.Anti Sa antibody was also found in 4 of 9 RA patients at the time when the diagnosis could not be established.The titers of RF in the anti Sa positive RA patients were higher than the negative ones.Conclusion Anti Sa antibody is a valuable diagnostic parameter for RA,especially in early RA and RF negative RA. Anti Sa antibody with both 50 000 and 55 000 bands could be related to disease activity.更多还原