血清葡萄糖6-磷酸异构酶在类风湿关节炎诊断中的意义

Diagnostic value of glucose-6-phosphate isomerase in rheumatoid arthritis

目的探讨葡萄糖6-磷酸异构酶(glucose-6-phosphate isomerase,GPI)在类风湿关节炎(rheumatoid arthritis,RA)诊断中的意义。方法用酶联免疫吸附试验(enzyme linked immunosorbent assay,ELISA)双抗体夹心法检测108例RA患者、42例系统性红斑狼疮(systemic lupus erythematosus,SLE)患者、50例其他风湿病患者及112例健康体检者血清GPI浓度,RA患者同时检测了抗环瓜氨酸肽抗体(anti-cyclic citrullinated peptide antibody,anti-CCP)、类风湿因子(rheuma-toid factor,RF)。结果GPI浓度:RA患者为(1.840±2.821)μg/ml,SLE患者为(0.143±0.426)μg/ml,其他风湿病患者为(0.074±0.279)μg/ml,健康体检者为(0.092±0.232)μg/ml。RA患者血清中GPI浓度显著高于SLE、其他风湿病患者和健康体检者(P<0.01)。Spearman等级相关分析显示RA患者GPI浓度与类风湿因子(RF)浓度呈显著正相关(r=0.622,P<0.01),与其他检测指标无相关性。结论GPI浓度大于0.209μg/ml时对RA的诊断有较高的特异性,其特异性可达93.7%,敏感性为56.5%。表明GPI的变化在RA诊断有较重要的意义。

Objective To investigate the diagnostic value of glucose-6-phosphate isomerase （GPI） in rheumatoid arthritis （RA）. Methods ELISA was used to measure the serum concentration of GPI in 108 patients with RA, 42 patients with systemic lupus erythematosus （SLE）, 50 patients with other autoimmune diseases and 112 normal controls. The levels of rheumatoid factor （RF） and anti-CCP antibodies were also assayed for RA patients. Results Serum GPI level in RA patients were （ 1. 840 ± 2. 821 ） μg/ml, while （0. 143 ±0. 426） μg/ml in SLE patients, （0.074 ±0. 279） μg/ml in other autoimmune diseases and （0.092 ± 0.232） μg/ml in normal controls. There was significant statistical difference among RA, SLE, other autoimmune diseases and the normal controls （P 〈0.01 ）. Spearman rank correlation analysis showed the concentration of GPI was positively correlated with RF level （ r = 0. 622, P 〈 0. 01 ）, but not with other parameters. Conclusion Serum GPI might be a new marker in diagnosis of RA. The serum concentions of GPI over the cut off value 0.209 μg/ml has a remarkable specificity in diagonising RA.