抗膜联蛋白A2抗体与类风湿关节炎疾病活动度及骨代谢的相关性研究

Measurement of anti-annexin A2 antibodies in patients with rheumatoid arthritis and the correlation with disease activity and bone metabolism

目的探讨抗膜联蛋白A2抗体与类风湿关节炎（HA）患者疾病活动度和骨代谢指标的相关性。方法①采用酶联免疫吸附试验（ELISA）法对118例RA患者、65例系统性红斑狼疮（SLE）患者、30例其他结缔组织病患者（包括硬皮病、混合性结缔组织病、干燥综合征、抗磷脂综合征等）及35名健康对照者进行抗膜联蛋白A2抗体检测，分析抗膜联蛋白A2抗体在各结缔组织病患者中的阳性率。②详细记录118例RA患者各项临床及实验室指标、腰椎（L1-4）和大转子骨密度值，评价抗膜联蛋白A2抗体与RA临床表现、疾病活动度及骨代谢指标的相关性。采用成组t检验、秩和检验及旷检验进行统计学分析。结果①结缔组织病患者中，抗膜联蛋白A2抗体的阳性率分别为：RA17例（14．4％），SLE18例（27．7％），其他结缔组织病5例（16．7％）；35名健康对照者中，抗膜联蛋白A2抗体的阳性率为0；②在118例RA患者中，抗膜联蛋白A2抗体阳性患者的受累关节数（肿胀和／或疼痛的关节数）明显高于抗膜联蛋白A2抗体阴性患者，差异有统计学意义（P〈0．05）；③在118例RA患者中，抗膜联蛋白A2抗体阳性患者血清N端骨钙素水平、既往骨折发生率、腰椎（L3、LA）骨密度值明显高于抗膜联蛋白A2抗体阴性患者，差异有统计学意义（P〈0．05）。结论抗膜联蛋白A2抗体可在多种自身免疫病中出现。抗膜联蛋白A2抗体可能作为反映骨代谢的有用指标。

Objective To evaluate the prevalence of anti-annexin A2 antibodies in patients with rheumatoid arthritis （RA） and their clinical significance. Methods ① Anti-annexin A2 antibodies were detected with enzyme-linked immunosorbent assay （ELISA） in the serum of patients with rheumatoid arthritis （n=118）, systemic lupus erythematosus （n=65）, other connective tissue diseases （n=30, including systemic sclerosis, MCTD, SS, APS et al）. Healthy blood donors （n=35） were used as controls. ② The clinical features, laboratory data, bone mineral density （BMD） of lumbar （1-4） and trochanter in 118 patients with RA were recorded in detail. Possible relationship between autoantibody to annexin A2 and clinical features, disease activity and bone metabolism markers in RA were analyzed. Comparisons between groups were performed by t-test, rank-sum test or X^2 test. Results ① Anti-annexin A2 antibodies were significantly more prevalent in patients with rheumatoid arthritis （14.4%）, systemic lupus erythematosus （27.7%）, and other connective tissue diseases （16.7%）, than in controls （0）. ② Compared with those RA patients with negative anti-annexin A2 antibodies, the occurrences of swollen and/or tender joints were significantly higher in the anti-annexin A2 positive patients （P〈0.05）. ③ The serum level of N-OST, the incidence of fracture, and the BMD of lumbar 3-4 were higher in the anti-annexin A2 positive patients （P〈0.05）. Conclusion Anti-annexin A2 antibodies can be detected in some autoimmune diseases. Anti-annexin A2 antibodies may be associ-ated with inflammatory activity, and possibly a significant marker of bone metabolism.