自身抗体阴性类风湿性关节炎临床及实验室特点

Clinical and laboratory characteristics of rheumatoid arthritis with self-antibodies negative

目的探讨自身抗体阴性类风湿关节炎(RA)患者的临床及实验室特点。方法采集26例自身抗体阴性RA患者性别、年龄、病程、晨僵时间、关节肿痛数、X线检查等临床指标,分析此类患者临床特点;随访中每半年做一次实验室检测,指标包括GPI、ACCP、AMCV及RF,分析此类患者实验室特点。结果 (1)这类患者平均年龄较大,病程较长,晨僵时间较短,关节肿痛数较少,X线骨侵蚀多集中于Ⅰ期;(2)在随访中,陆续有患者被检出自身抗体,半年后检出4例(15.38%),一年后检出9例(34.62%),一年半后检出16例(61.54%),两年后检出19例(73.08%)。结论随病情发展和变化,一些患者自身抗体也会陆续被检出,理论上存在病情变化加重的趋势,应引起临床高度的重视。

Objective To discuss the clinical and laboratory characteristics of rheumatoid arthritis with self-antibodies negative.Methods Collected clinical indicators of 26 cases autoantibody negative RA patients＇ gender, age, duration, time of morning stiffness, joint swelling pain numbers, and X-ray analysis results to analyze such patients＇ clinical characteristics; Follow-up once every half a year to do laboratory tests, indicators including the GPI, ACCP, AMCV and RF, made laboratory characteristics analysis in such patients.Results（1） In these patients,the average age was larger, longer course, the shorter the time of morning stiffness, joint swelling and pain with less number, X ray bone erosion were more concentrated in phase Ⅰ;（2） during the follow-up period, one after another was detected in patients with autoantibodies, six months after the diagnosis of 4 cases（15.38%）. A year later detected in 9 cases（34.62%）, a year and a half later detected in 16 cases（61.54%）, and two years later detected in 19 cases（73.08%）. Conclusion autoantibodies negative RA is not uncommon, compared with autoantibody positive patients, these patients do exist relatively light in condition in the same period,but with the progression and changes of the disease, autoantibodies in some patients will be detected continuously, it theoretically exist the tendency to increase the severity of the disease and should cause a high degree of clinical attention.