【摘要】 目的本研究主要探讨抗环瓜氨酸肽抗体(抗CCP抗体)及其血清水平与早期类风湿关节炎(RA)的疾病活动度,骨侵蚀等临床指标的相关性。方法入选87例早期RA患者,分别测定抗CCP抗体I、gG-RFI、gM-RFI、gA-RF,并记录肿胀关节数、压痛关节数、疾病活动度(DAS-28)等临床指标。分析抗CCP抗体阳性与阴性患者临床指标的变化,探讨血清抗CCP抗体水平与临床指标及骨侵蚀的关系。结果87例早期RA患者中,抗CCP抗体阳性54例(62.1%),RF阳性56例(64.4%)。抗CCP抗体阳性组患者肿胀关节数、压痛关节数明显多于阴性组(P=0.000和0.000);DAS-28评分明显高于阴性组(P=0.000);X线更易出现骨侵蚀(P=0.000)。血清抗CCP抗体水平与肿胀关节数、压痛关节数、DAS-28评分呈显著正相关(r=0.601,P=0.000;r=0.574,P=0.000;r=0.698,P=0.000),而与ESR呈弱正相关(r=0.322,P=0.018),与血清IgG-RFI、gA-RFI、gM-RF不具有相关性。62例早期RA患者存在骨侵蚀,占71.3%,25例患者无骨侵蚀,占28.7%,两组间抗CCP抗体水平I、gA-RF、ESR差异有统计学意义(P=0.000,0.022和0.004)。不同X线分期,血清抗CCP抗体水平差异有统计学意义(P=0.000)。结论抗CCP抗体及其血清水平与肿胀关节数、压痛关节数、DAS-28及骨侵蚀程度相关,可作为评价疾病活动度以及预测骨侵蚀破坏的重要指标。更多还原

【Abstract】 Objective To compare the association of anti-cyclic ciryellinated peptide antibody(anti-CCP)and their serum levels,with disease activity score for 28(DAS-28)、swollen joint count(SJC)、tender joint count(TJC),bone erosion in a cohort of patients with early rheumatoid arthritis(RA).Methods Anti-CCP、IgG-RF、IgM-RF、IgA-RF were detected in 87 cases of early RA,IgG-RF、IgM-RF、IgA-RF、ESR and DAS-28 were compared between patients with anti-CCP positive and negative,and the correlations among the level of anti-CCP and clinical manifestations、laboratory findings and bone erosion were analyzed.Results From 87 early RA patients,62.1% were anti-CCP positive,64.4% were RF positive,anti-CCP positive patients presented with higher SJC(P=0.000) and TJC(P=0.000),and exhibited more active disease,expressed by higher DAS-28(p=0.000),and erosive disease was significantly higher than anti-CCP negative patients.The serum levels of anti-CCP showed a significant correlation with SJC(P=0.000)、TJC(P=0.000) and DAS-28(P=0.000) and weak correlation with ESR(P=0.018),but there is no correlation with IgG-RF、IgM-RF and IgA-RF.71.3% were patients with erosive disease.The serum levels of antiCCP、IgA-RF and ESR were of statistical significance between patients with erosive disease and non-erosive disease.The difference of anti-CCP level in blood serum in different x-ray periods(except period Ⅳ) is of statistical significance.Conclusion The presence of anti-CCP and their serum levels is associated with SJC、TJC、DAS-28 and bone erosion.Anti-CCP can be used as evaluation of disease activity and prediction of bone erosion.更多还原