血清与关节滑液软骨寡聚基质蛋白检测在类风湿关节炎中的应用

Application of cartilage oligomeric matrix protein levels in serum and synovial fluid in diagnosis of rheumatoid arthritis

目的检测类风湿关节炎(Rheumatoid Arthritis,RA)患者血清与关节滑液软骨寡聚基质蛋白(Cartilage Oligomeric Matrix Protein,COMP)的水平,探讨其在RA中的意义。方法采用ELISA法测定RA组和正常对照组的血清与关节滑液COMP水平;同时检测血清类风湿因子(RF)、抗环瓜氨酸肽(CCP)抗体、C反应蛋白(CRP)、血沉(ESR)、关节疼痛数、肿胀数及X线分级;并对RA组治疗后进行血清COMP水平测定。结果RA组血清COMP水平明显高于对照组(P<0.01);在RA活动组和RA非活动组,亦有显著差异(P<0.01)。RA组关节滑液COMP水平高于血清水平(P<0.05),且与血清水平显著正相关(r=0.73,P<0.01);COMP水平与RA患者的ESR、CRP、关节疼痛数、肿胀数呈正相关(P<0.01)。治疗后血清COMP水平与治疗前差异有统计学意义(P<0.01)。结论COMP水平与RA的活动程度及关节滑膜炎相关,是RA疾病进展与改善的血清学指标。

Objective To measure the cartilage oligomeric matrix protein（COMP） level in serum and synovial fluid（SF） and to study its significance in diagnosis of rheumatoid arthritis（RA）.Methods COMP levels in serum and SF,as well as serum rheumatoid factor（RF）,anti-cyclic citrullinated peptide antibodies（CCP）,C-reactive protein（CRP） level,and erythrocyte sedimentation rate（ESR） were measured by ELISA in RA and control groups.Arthralgia and swelling index and X-Ray classification were detected.Serum COMP level in RA group was measured after treatment.Results The serum COMP level was significantly higher in RA group than in control group（P0.01）.A significant difference was found in serum COMP level between patients with active and inactive RA（P0.01）.The COMP level was higher in synovial fluid than in serum（P0.05）.There was a positive correlation between COMP level in serum and SF（r=0.73,P0.01）.The COMP level was positively correlated with ESR,CRP levels and arthralgia and swelling index（P0.01）.A significant difference was observed in serum COMP level before and after treatment（P0.01）.Conclusion COMP level is related with the activity of RA and arthrosynovitis,and can thus be used as a serological index of the disease progress and improvement.