葡萄糖-6-磷酸异构酶抗原、抗体测定在类风湿关节炎诊断中的作用

The diagnostic significance of G6PI and anti-G6PI Ab of patients with rheumatoid rthritis

目的探讨血清和关节液中葡萄糖-6-磷酸异构酶(G6PI)抗原和抗体含量变化与类风湿关节炎(RA)病情活动状态的关系。方法采用酶联免疫吸附试验(ELISA)测定RA患者176例、其他免疫疾病患者35例、健康体检者100例的血清标本及RA患者33例、其他免疫疾病患者11例的关节液标本中G6PI抗原和抗体水平。结果 G6PI抗原在诊断RA中的敏感度和特异度分别为75.0%和93.3%;176例RA患者血清G6PI含量为(4.37±8.65)μg/mL,显著高于疾病对照组(0.07±0.07)μg/mL(P<0.01)和健康对照组(0.34±1.30)μg/mL(P<0.01);在RA组中,活动期患者血清G6PI含量为(7.61±10.69)μg/mL,显著高于缓解组(0.47±0.47)μg/mL(P<0.01);关节液G6PI表达量也显著高于疾病对照组,分别为(1.39±0.58)μg/mL和(0.16±0.17)μg/mL(P<0.05)。以波长450 nm吸光度值(A_(450nm))表示抗体含量,G6PI抗体的含量在RA组、疾病对照组以及健康对照组之间差异无统计学意义(P>0.05),在RA活动组与非活动组之间差异无统计学意义(P>0.05);关节液中G6PI抗体含量RA患者与疾病对照组差异无统计学意义(P>0.05)。结论 G6PI抗原在RA患者中高表达,并且与疾病活动性有密切关系。因此G6PI抗原可以作为敏感度、特异性俱佳的RA辅助诊断指标,尤其对病情判断有重要作用。而G6PI抗体在RA的诊断中价值不大,与病情活动亦无关。

Objective To investigate the level of glucose-6-phosphate isomerase（G6PI） and anti G6PI antibodies（anti-G6PI） in serum and synovia fluid of patients with rheumatoid arthritis（RA） and to study the association with the activity of RA. Methods The level of G6PI and anti G6PI in serum samples from 176 RA patients,35 non-RA patients and 100 healthy donors and in synovia fluid samples from 33 RA patients and 11 non RA patients were tested by ELISA. Results The sensitivity and specificity of G6PI in the RA patients were 75.0% and 93.3 % respectively. The level of serum G6PI in 176 RA patients was （4.37±8.65）μg/ ml., which was significantly higher than that of the non-RA patients（0.07±0.07）μg/mL, （P〈0.01） and the health controls（0.34 ±1.30）μg/mL,（P〈0.01）. Eespecially, there was a significant deifference between the active phase（7.61±10.69）μg/mL and the inactive phase（0.47±0.47）μg/mL in G6PI level（P〈0.01）. In synovia fluid,the level of G6PI was significantly higher in RA groups（1.39±0.58μg/mL） than that in non P,A patients（0. 16±0. 17）μg/mL, （P〈0. 05）. With the values of the anti-G6PI＇s A450nm there were no obvious differences among RA patients, non RA patients and heahh controls. Also there was no difference between the active phase and the inactive phase. In synovia,the difference between RA patients and health controls were not obervious. Conclusion The increased expression of G6PI may play a pathological rote in the development of RA,and it may be correlated with the activity of RA. It was a marker of high sensitivity and specificity for the decetion of RA. However,anti-G6PI has little value on the diagnosis of RA.