抗核周因子滴度在类风湿性关节炎中的意义

The titer of APF in rheumatoid arthritis

目的 探讨抗核周因子 (APF)滴度在类风湿性关节炎 (RA)中的临床意义。方法 间接免疫荧光法检测 1 4 3例RA患者血清中IgG型APF ,阳性血清作倍比稀释至其滴度为 1∶2 5 6 0。所得结果结合临床进行分析。结果 根据APF滴度将 97例APF阳性RA分为 4组 ,即 1∶1 0～ 1∶2 0组 6例 ,1∶4 0～ 1∶80组 1 8例 ,1∶1 6 0～ 1∶32 0组 5 2例 ,大于或等于 1∶6 4 0组 2 1例。压痛关节指数、肿胀关节指数、医生病情活动评价、患者病情活动评价、ESR、CRP、RF阳性率、RF平均滴度等随APF滴度增加而呈上升趋势 ;APF滴度与RF滴度呈正相关。结论 APF的滴度一定程度反应了RA病情的活动性 ,可能为RA预后不良的指标之一。

Aim To investigate the association between titer of antiperinuclear factor(APF) and the disease activity and severity of rheumatoid arthritis.Methods APF was measured with indirect immunofluorescence technique in 143 patients with RA, and all APF positive sera were diluted to 1∶ 2 560 .Based the titer of APF,the patients were divided into 4 groups(1∶10～1∶20, 1∶40～1∶80,1∶160～1∶ 320 ,1∶640～).The ESR,CRP,RF tender joint count and swollen joint count,patient's and physician's global assessment of disease activity,modified Sharp's radiological progression scores were compared between every groups.Results The patient's global assessment was significantly higher in the higher titer groups. Although no statistical significance can was obtained, the level and occurrence of RF, tender and swollen joint count, physician's global assessment of disease activity, and modified sharp's radiological progression scores were also higher in the higher titer groups; The titer of APF was correlated to the titer of RF (r=0 32,P=0 049 ). Conclusion The titer of APF might indicate the disease activity of RA and a bad prognosis.