血清中葡萄糖-6-磷酸异构酶在类风湿关节炎诊断中的意义

The Role of Serum Glucose-6 Phosphate Isomerase Level in Diagnosis of 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)双抗体夹心法检测60例RA患者,26例其他风湿性疾病患者和100例健康人群中血清GPI抗原的浓度,并检测类风湿因子(RF)、抗环瓜氨酸肽(CCP)抗体、抗角蛋白抗体(AKA),RA患者还检测了C反应蛋白(CRP)和血沉(ESR)。结果:RA组的GPI浓度明显高于其他风湿性疾病组及健康对照组,且GPI水平在RA活动组与非活动组差异亦存在统计学意义(P<0.05);当GPI为0.49μg/mL时,其敏感度为73.7%,特异度为92.3%;GPI与RF有显著相关性(P<0.05),而与其他指标CRP、ESR无相关性(P>0.05);GPI和抗CCP抗体对RA诊断的敏感度和特异度无明显差异。结论:GPI、抗CCP抗体、AKA与RF联合检测,对类风湿因子阴性患者在诊断上可起到互补作用,GPI对RA的诊断及活动性判断具有广泛的临床应用及研究前景。

Objective： Evaluate the role of serum glucose-6 phosphate isomerase （GPI） as a disease related antigen in diagnosing rheumatoid arthritis（RA）. Methods： We used Enzyme-Linked ImmunoSorbent Assay（ ELISA ） to exam serum GPI level from 60 rheumatoid arthritis patients, 26 other rheumatologic patients and 100 healthy controls ; we also tested the rheumatoid factor （ RF）, anti-Cyclic Citrullinated Peptide （CCP） antibody and anti-keratin antibody （AKA）. In the rheumatoid arthritis patient group, C-reative protein （CRP） and erythrocyte sedimentation rate（ ESR ） level were also tested. Results： RA group＇s GPI concentration was significantly higher as compared the other rbeumatologic disease group and the health controls, and there was a significant difference between the active phase and inactive phase in GPI level（ P 〈 0.05 ） ; At a GPI concentration of 0.49 μg/ml, the sensitivity of test reached 73.7% and the specificity 92.3%. GPI was shown to be significantly related to rheumatoid arthritis（ P 〈 0. 05）, while other factors such as CRP, ESR were not（P 〉0.05）. There was no obvious difference between GPI and anti CCP antibody in terms of sensitivity and specificity for diagnosis of RA. Conclusion： Combining GPI, RF, AKA and anti CCP antibody tests seemed useful to confirm rheumatoid arthritis patient who are RF negative. GPI holds great promise as a diagnosis tool for RA and its activity, which warrants further investigation.