摘要
目的 检测儿童系统性红斑狼疮（JSLE）患者血清抗环瓜氨酸肽（CCP）抗体水平,了解抗CCP抗体在该病中的阳性检出率以及探讨其与关节炎表现相关性.方法 采用第3代抗CCP抗体酶联免疫吸附试验（ELISA）检测47例JSLE、54例幼年特发性关节炎（JIA）患者和40名年龄匹配的健康儿童血清中抗CCP抗体水平,并分析该抗体与JSLE实验室指标及临床特征,尤其是关节表现之间关系.正态分布的计量资料比较采用t检验,非正态资料比较采用Mann-Whitney U检验,率的比较采用χ2或Fisher精确检验.结果 47例JSLE患儿中6例为抗CCP抗体阳性,抗体阳性率明显高于健康对照组（13%与0,P＜0.05）,与JIA组（26%）差异无统计学意义（P=0.098）.抗CCP抗体阳性JSLE患儿中类风湿因子（RF）阳性率显著高于阴性患者（83%与15%,P＜0.01）,在其他实验室指标和包含关节炎发生率等临床特征方面差异均无统计学意义（67%与51%,P＞0.05）.47例JSLE患儿中以关节炎起病者25例,无一例出现关节畸形或影像学改变,关节受累与未受累者间抗CCP抗体水平及阳性率比较差异均无统计学意义（16%与9%,P＞0.05）;3例在长达3年病程中始终伴有关节疼痛、活动受限患儿抗CCP抗体均呈阴性.结论 抗CCP抗体可在系统性红斑狼疮患儿血清中检出,在同JIA作鉴别诊断时应引起重视,但抗CCP抗体与JSLE关节炎发生、持续并无明显联系.
Objective To determine the prevalence of antibodies to cyclic citrullinated peptides （antiCCP） in patients with juvenile-onset systemic lupus erythematosus （JSLE） and its potential clinical significance. Methods Anti-CCP was measured in sera from patients with JSLE （n=47）, juvenile idiopathic arthritis （JIA, n=54） and the sera from age-matched healthy children （n=40） using the third generation of anti-CCP ELISA commercial kit. The association of anti-CCP with other laboratory parameters and clinical features, especially arthritic symptoms in JSLE was also analyzed. T-test, Mann-Whitney U test, Chi-square and Fisher＇s exact test were used for statistical analysis. Results Out of the 47 JSLE patients, 6 （13%） were anti-CCP positive, which was significantly higher than that of the healthy controls（ 13% vs 0, P〈0.05 ）, but not different from that of the JIA group （26%, P=0.098）. RF was more prevalent in JSLE patients with anti-CCP than patients without （83% vs 15%, P〈0.01 ）, but there was no difference in other laboratory parameters and the clinical features ineluding the occurrence of arthritis （67% vs 51%, P〉0.05）. As one of the initial symptoms, arthritis was observed in 25 of 47 JSLE patients and no one had developed deforming arthropathy.There was no statistical difference in anti-CCP positivity between JSLE patients with and without articular involvement （ 16% vs 9%, P〉0.05 ）. Anti-CCP was not detected in any of the 3 patients with JSLE who had experienced joint pain and limited activity during 3 years follow-up. Conclusion Anti-CCP could be detected in patients with JSLE. It is noteworthy when differentiate from juvenile idiopathic arthritis, but the presence of anti-CCP does not relate with the occurrence of arthritis at presentation and persistence of arthritis in JSLE.
出处
《中华风湿病学杂志》
CAS
CSCD
北大核心
2010年第10期698-701,共4页
Chinese Journal of Rheumatology
关键词
儿童
红斑狼疮
系统性
抗环瓜氨酸肽抗体
幼年特发性关节炎
Child
Lupus erythematosus, systemic
Antibodies to cyclic citrullinated peptides
Juvenile idiopathic arthritis
