摘要
目的了解抗Ⅱ型胶原(CⅡ)抗体在类风湿关节炎(RA)中的临床意义及口服鸡CⅡ对血清中抗CⅡ抗体的影响。方法以鸡CⅡ蛋白作为包被抗原,采用酶联免疫吸附试验(ELISA)检测70名健康献血者、113例活动期RA患者,其中病程≤1年的早期患者30例;同时检测19例患者在口服鸡CⅡ90"g/d治疗前和治疗12、24周后血清中的抗CⅡ抗体水平。结果①RA患者血清抗CⅡ抗体水平明显高于健康对照组;RA患者血清抗CⅡ抗体阳性率为37.2%(42/113),正常对照组阳性率为2.9%(2/70),两者比较差异有统计学意义(P<0.01);②早期RA患者抗CⅡ抗体阳性率73.3%(22/30),而病程>1年的RA患者抗CⅡ抗体阳性率为24.1%(20/83),两组差异具有统计学意义(P<0.05);&%比较抗CⅡ抗体阳性组和阴性组其他相关指标:抗CⅡ抗体阳性组42例,阴性组71例,两组类风湿因子(RF)阳性率分别为83.3%(35/42)和43.7%(31/71),两组比较差异有统计学意义(P<0.05);抗环瓜氨酸肽(CCP)抗体阳性率分别为90.5%(38/42)和52.1%(37/71),两组比较差异有统计学意义(P<0.05);同时抗CⅡ抗体阳性组的血沉(ESR)、C反应蛋白(CRP)水平均高于抗CⅡ抗体阴性组;两组在日常生活能力及骨质破坏方面差异无统计学意义;④口服CⅡ治疗前和治疗12、24周后,RA患者血清抗CⅡ抗体水平有逐渐下降趋势,但差异无统计学意义。结论RA患者抗CⅡ抗体明显升高,尤其在早期RA患者有较高的阳性率;抗CⅡ抗体阳性患者RF、抗CCP抗体阳性率明显高于阴性患者,同时ESR、CRP亦明显升高;口服CⅡ治疗后抗体水平有逐渐下降趋势。因此,抗CⅡ抗体在RA发病中可能起着重要的作用,可作为早期诊断、判断病情活动的指标之一;口服CⅡ对CⅡ抗体的影响有待进一步观察。
Objective To explore the significance of serum anti-type- Ⅱ -collagen antibody in rheumatoid arthritis （RA） and the effect of oral chicken type Ⅱ collagen （CC Ⅱ ） on it. Methods CC Ⅱ was used as coating antigen to detect the anti-type- Ⅱ -collagen antibody by enzyme-linked immunosorbent assay （ELISA） in the sera of 70 normal individuals, 113 active RA and 19 RA patients were treated with oral CC Ⅱ at does of 90 μg/d for 12 and 24 weeks, and their clinical data were analyzed. Results In active RA patients, the level of anti-C Ⅱ antibody was higher than that in healthy controls.. The positive rates of anti-C Ⅱ antibody in patients with RA were 37.2% （42/113）, 73.3% （22/30） in early RA （duration≤1y）, 24.1% （20/83） and 2.9% （2/70） in chronic RA （duration〉ly） and healthy controls respectively. Anti-C Ⅱ antibody positive group showed higher prevalence rate of rheumatoid factor （RF） and anti-cyclic citrullinated peptide antibody （anti-CCP） （83.3%, 90.5%） than those of anti-C Ⅱ negative group （43.7%, 52.1%, P〈0.05）, respectively. The presence of anti-CⅡ antibody was associated with higher ESR and CRP level than negative group. Serum level of anti-C Ⅱ antibody had the tendency of decreasing after treated with CⅡ for 12, 24 weeks, but not statistically significant. Conclusions The positive rates and the level of anti-C Ⅱ antibodies in patients with RA are significantly high, especially in early RA. Patients with positive anti-CⅡ antibody have higher positive rate of RF, anti-CCP antibody and higher level of ESR, CRP than patients with negative anti-C Ⅱ antibodies. Anti-C Ⅱ antibodies may serve as a supplemental diagnosing parameter for early RA and help to evaluate the disease activity. The effect of oral CⅡ treatment on anti-CⅡ antibody needs to be further observed.
出处
《中华风湿病学杂志》
CAS
CSCD
2006年第4期217-219,共3页
Chinese Journal of Rheumatology
基金
安徽省卫生厅科研基金资助项目(2002A009)
安徽省教育厅自然科学基金资助项目(2004kj216)
关键词
关节炎
类风湿
抗Ⅱ型胶原抗体
口服耐受
Arthritis, rheumatoid
Anti-type Ⅱ collagen antibody
Oral tolerance
