6-磷酸葡萄糖异构酶抗原检测在类风湿性关节炎中的诊断价值

Diagnostic Value of Glucose-6-phosphate Isomerase in Patients with Rheumatoid Arthritis

目的检测类风湿性关节炎(RA)患者血清6-磷酸葡萄糖异构酶(GPI)抗原水平,探讨其在RA诊断中的价值。方法选取RA118例,非RA106例,正常对照组60例。对上述284份血清进行GPI抗原、CCP抗体及类风湿因子(IgM-RF)检测,分析GPI抗原水平与CCP抗体、IgM-RF的相关性。结果GPI抗原的阳性率在RA中为84.74%,非RA中为5.66%,正常人均为阴性。GPI抗原、CCP抗体及IgM-RF对RA诊断的敏感性和特异性分别为GPI84.74%、96.39%,CCP60.17%、95.18%,IgM-RF80.51%、79.52%。GPI抗原与CCP抗体在RA患者血清中阳性率的差异有显著性(P<0.01),与IgM-RF的差异无显著性(P>0.05)。相关分析显示3种方法的检测结果间存在相关性,两两联合检测可提高诊断效能。结论ELISA法检测血清GPI抗原简便、结果可靠,对RA诊断具有高灵敏度和特异性,可作为RA患者一个新的诊断指标。

Objective To detect glucose-6-phosphate isomerase （GPI） in patients with rheumatoid arthritis（RA） and explore its diagnostic value. Methods GPI,anti-CCP antibody and IgM-RF were detected in 284 serum samples ,118 from patients with established RA and 166 from non-RA controls. The correlations were analyzed among GPI,anti-CCP and IgM-RF. Results Among 118 patients with RA,106 patients showed positive GPI （84. 74%）. Whereas, the positive percent was only 5.66%in 106 non-RA patients. The sensitivities and specificities of GPI,anti-CCP and IgM-RF were 84. 74% and 96.39%;60.17% and 95.18%; 80. 51% and 79.52% in RA respectively. The data showed that there was a significant difference between the results of GPI and anti-CCP assaying（P〈0. 01） by two methods. However,no difference was found between GPI and IgM-RF assaying（P〉0. 05）. GPI was associated with anti-CCP and IgM-RF. The combination of the two assays could increase the diagnostic value. Conclusion Detecting GPI by ELISA may be a brief,standard and reliable method. It might present more sensitive and specific in clinical diagnosis on RA. GPI may be a useful parameter for the diagnostic work-up of rheumatoid arthritis.