银屑病关节炎患者抗核周因子的检测

Antiperinuclear factor in psoriatic arthritis

目的 评价抗核周因子 (antiperinuclear factor,APF)在诊断、鉴别诊断银屑病关节炎与类风湿关节炎的作用。方法 以人颊黏膜上皮细胞为底物用间接免疫荧光法对 4 0例银屑病关节炎、6 4例寻常型银屑病、15 1例非炎症性风湿病、2 2 0例类风湿关节炎 (15 7例类风湿因子阳性 ,6 3例类风湿因子阴性 )的患者以及 176名健康对照者进行了血清 APF的检测。结果 银屑病关节炎患者 APF阳性率 7.5 % ,比健康对照者增高 (1.1% ,P<0 .0 5 ) ,与寻常型银屑病 (3.1% )和非炎症性风湿病 (3.3% )患者阳性率相似 ,差异无统计学意义 ,但低于类风湿因子阴性的类风湿关节炎患者 (5 4 .0 % ,P<0 .0 0 1)和类风湿因子阳性的类风湿关节炎患者 (83.4 % ,P<0 .0 0 1) ,3例 APF阳性的银屑病关节炎均为多关节炎累及 ,其类风湿因子阳性。结论 APF检测有助于银屑病关节炎和类风湿关节炎的鉴别和银屑病关节炎的分型。

Objective To evaluate whether antiperinuclear factor (APF) determination is useful for the diagnosis of psoriatic arthritis (PA).Methods APF in sera from patient with psoriatic arthropathy (PA,n=40),psoriasis vulgaris (n=64),noninflammatory rheumatic disease (NIRDs,n=151),rheumatoid arthritis (RA,n=220) both with negative (n=63) and positive (n=157) rheumatoid factor (RF) tests,as well as from 176 healthy controls was determined,using an indirect immunofluorescence test on epithelial cells from human buccal mucosa as a substrate.Results In patients with PA,7.5% of the serum samples were APF-positive.The incidence was greater than in healthy controls (1.1%,P<0.05),similar to that with uncomplicated psoriasis (3.1%,P=NS) and NIRDs (3.3%,P=NS),and lower than in RF-negative (54.0%,P<0.001) and RF-positive (83.4%,P<0.001) patients with RA.Three APF-positive patients with PA had symmetric joint involvement.Conclusion The APF test may be useful in differentiating PA from RA,and APF may be specific for symmetric polyarthritis.