血清葡萄糖-6-磷酸异构酶抗原在类风湿关节炎诊断中的意义

Diagnostic value of glucose-6-phosphate isomerase in rheumatoid arthritis

目的:探讨血清中葡萄糖-6-磷酸异构酶(GPI)抗原检测对类风湿关节炎(RA)的诊断意义。方法:用酶联免疫吸附试验(ELISA)双夹心抗体法检测120例RA患者、58例其他风湿病患者和40例健康人群中血清GPI抗原浓度,同时用速率散射比浊法检测类风湿因子(RF-IgM)。结果:①RA患者血清中GPI浓度明显高于其他风湿病组和健康组(P<0.01),②GPI和RF-IgM的敏感度分别是63.33%和77.50%,特异度分别是84.69%和85.71%,ROC曲线下面积分别是0.838和0.911。根据ROC曲线判断其最佳临界值分别为0.173mg/L和15.0U/ml。③GPI与RF-IgM之间存在显著相关性。④GPI抗原与HS-ESR、CRP、晨僵时间、关节肿胀数、关节压痛数和握力等存在相关(P<0.05或P<0.01)。结论:GPI抗原在RA患者血清中显著升高,对RA具有良好的敏感度和特异度,是诊断RA的良好指标。GPI与RF-IgM之间存在显著相关性,并与ESR、CRP、晨僵时间、关节肿胀数、关节压痛数和握力等病情活动性指标存在相关。GPI能一定程度反映RA的临床病情,可作为RA的血清学指标。

Objective To investigate the diagnostic value of glucose - 6 - phosphate isomerase （GPI） detected by an enzyme linked immunosorbent assay （ELISA） in patients with rheumatoid arthritis（RA）. Method The GPI was tested by ELISA in serum samples from 120 patients with RA,58 non - RA controls with various rheumatic diseases, and 40 healthy individuals. The level of rheumatoid factor （RF） were also assessed in three groups. Results Serum GPI level in RA patients was significantly higher as compared with the other rheumatic diseases and the health controls. There was statistical significant difference between RA patients and patients with other rheumatic diseases（ P 〈 0.01 ）. Receiver operator curve analysis （ROC） showed an opitium cut off level for GPI at 0. 173mg/L. The sensitivity of GPI was 63.33%, the specificity was 77.50% in RA. GPI was associated with RF. GPI was associated with disease activity index by Spearman＇s eorrelation analysis. Conclusion GPI is a valuable diagnostic tool and a useful additional marker for RA. The detection of GPI is useful for the diagnosis of RA, especially combined with RF.