摘要
目的了解抗核周因子（ＡＰＦ）对类风湿关节炎（ＲＡ）的诊断价值，并探讨其与ＲＡ病情的关系。方法以健康人颊粘膜细胞为抗原，采用间接免疫荧光法检测１４３例ＲＡ、１８４例其他风湿病患者和１６８例正常人的血清ＡＰＦ；ＲＡ病人的红细胞沉降率（ＥＳＲ）、类风湿因子（ＲＦ）、抗鼠食管角质层抗体（ＡＫＡ）、抗ＲＡ３３抗体、医生和患者病情活动性评价、压痛及肿胀关节指数、放射学病情进展改进的Ｓｈａｒｐ评分也同时评估。结果以１∶１０为阳性阈值，ＡＰＦ对ＲＡ诊断的敏感性为６７８％（９７／１４３），对照组９例阳性，特异性９７４％；４１例早期ＲＡ检出率为６５９％（２７／４１）；ＡＰＦ阳性ＲＡ的ＲＦ阳性率及滴度较阴性者高（７９３％对５１９％，１∶８０对１∶５２），ＥＳＲ、医生和患者病情活动性评价、ＡＫＡ阳性率也高于阴性组；抗ＲＡ３３抗体阳性率Ｓｈａｒｐ评分在两组间无差异。结论ＡＰＦ有助于ＲＡ的诊断及早期诊断，可能是ＲＡ病情活动性及严重性指标之一。
Objective To
determine the significance of antiperinuclear factor (APF) in the diagnosis of rheumatoid arthritis
(RA),and its relationship with disease activity and severity. Methods Based on the antigenic
substrate in human bucca mucosa cells,APF was measured with indirect immunofluorescence
technique in 143 patients with RA,184 with miscellaneous rheumatic diseases and 168 healthy
individuals.The erythrocyte sedimentation rate (ESR),Creactive protein,RF,antibodies to the
stratum of rat oesophagus (AKA),antiRA33 antibodies,patients and physicians global
assessment of disease activity,tender joint count,swollen joint count and modified Sharps
radiological progression scores were compared between APF positive and negative RA
patients. Results At the titer of 110,APF was detected in 678% (97/143) of RA patients,and 9
cases of control group.The diagnostic specificity for RA was 974%.The occurrence of APF in the
early RA was 659% (27/41).The patientss and physicians global assessment of disease
activity,ESR,AKA,RF positive rate and its mean titer in APFpositive RA cases were significantly
higher than those in APFnegative ones. Conclusion APF is a valuable diagnostic tool and a
useful additional marker for RA,and might be a useful prognostic marker and a test of the
disease activity of RA,especially it is helpful in the early diagnosis of RA.
出处
《中华风湿病学杂志》
CAS
CSCD
1999年第2期100-103,共4页
Chinese Journal of Rheumatology
