人细小病毒B19感染在类风湿性关节炎发生中的作用

THE ROLE OF HUMAN PARVOVIRUS B19 INFECTION IN RHEUMATOID ARTHRITIS

目的探讨人细小病毒B19感染与类风湿性关节炎(RA)的关系。方法采用聚合酶链反应和酶联免疫吸附法对56例类风湿性关节炎病人(观察组)及55例非类风湿性关节炎病人(对照组)进行血清B19-DNA和B19-VP2-IgM检测,并对31例RA病人和11例对照组病人骨髓进行了B19-DNA检测。结果观察组血清B19-DNA阳性率为33.9%,对照组为5.5%,两组差异有极显著性(χ2=14.69,P<0.01)。观察组血清B19-VP2-IgM阳性率为25.0%,对照组为3.6%,两组差异有显著性(χ2=10.27,P<0.05)。在56例RA病人中,12例B19-DNA、B19-VP2-IgM阳性,2例仅B19-VP2-IgM阳性,7例仅B19-DNA阳性,B19-DNA、B19-VP2-IgM同时阴性35例,两者一致率为83.9%(P>0.05)。成年RA病人骨髓标本中B19-DNA阳性率为51.6%,与对照组(9.1%)比较差异有显著性(P=0.02)。讨论RA病人B19病毒感染率较高,B19病毒感染与RA密切相关。

Objective To investigate the role of human parvovirus B19 （B19） infection in the pathogenesis of rheumatoid arthritis （RA）, Metkods Fifty six RA patients （study group） and 55 non-RA patients （control group） were enrolled, Serum B19 DNA and B19-VP2-IgM were detected in both groups by enzyme immunoassay. Bone marrow B19-DNA was measured was well in 31 RA patients and in 11 controls, Results The positive rate of serum B19 DNA in study group was 33, 9% vs 5.5% for the controls. The different was significant （Χ^2 = 14.69,P〈~0.01）. The positive serum B19 VP2 IgM in study group was 25.0% vs 3.6% for the controls. Of the 56 RA patients, both B19-DNA and B19 VP2 IgM were positive observed in 12, two showed only B19 VP2 IgM positive, and seven showed only B19-DNA positive. Both B19-DNA and B19-VP2-IgM negative in 35 cases, the concordance rate being 83.9%. The positive rate of bone-marrow B19 DNAinRA was 51.6% compare with 9.1% for the controls. Conclusion There is a higher infection rate of HPVB19 in RA patients. HPVB19 infection is closely related with RA.