抗突变型瓜氨酸波形蛋白抗体在诊断类风湿性关节炎中的意义

The Diagnostic Value of Anti-mutated Citrullinated Vimentin Antibodies in Patients with Rheumatoid Arthritis

目的探讨抗突变型瓜氨酸波形蛋白抗体(anti-mutated citrullinated vimentin antibody,Anti-MCV)在诊断类风湿性关节炎(rheumatoid arthritis,RA)中的价值。方法选取确诊的RA患者51例(RA组)、非RA自身免疫性疾病患者36例(疾病对照组)和健康查体者30例(对照组)作为研究对象。根据临床资料计算DAS28评分,将RA组分为活动组和稳定组。采用酶联免疫吸附法(ELISA)检测血清中的抗MCV抗体、抗环瓜氨酸肽抗体(抗CCP抗体)及白细胞介素-6(IL-6)水平,采用免疫比浊法检测血清中C-反应蛋白(CRP)的浓度水平,并进行比较。结果 RA组抗MCV抗体的浓度水平显著高于非RA组和对照组(P均<0.01);活动组抗MCV抗体的浓度水平显著高于稳定组和对照组(P均<0.01);经Spearman相关性分析,抗MCV抗体的浓度水平与CRP及IL-6呈正相关,而与DAS28无相关性;抗MCV抗体与抗CCP抗体的诊断效率无显著差异,但是灵敏度高于抗CCP抗体。结论抗MCV抗体具有较高的灵敏度和特异性,并且能提示RA病情的活动情况,可以成为新的辅助RA诊断的血清学指标。

Objective To investigate the diagnostic value of Anti-mutated Citrullinated Vimentin（ anti-MCV）antibodies in patients with rheumatoid arthritis（ RA）. Methods Fifty-one patients diagnosed with rheumatoid arthritis were enrolled in the study. Disease activity was evaluated by calculating the 28-joint Disease Activity Score（ DAS28） based on the clinical information RA patients were divided into active group and inactive group according to the DAS28 score. The antibodies and interleukin-6（ IL-6） were measured by enzyme linked immunosorbent assay（ ELISA） and C-reactionprotein（ CRP） by nephelometry. Results The serum levels of anti-MCV antibodies increased significantly in RA group than the other two groups（ P 〈 0. 01）.The serum levels of anti-MCV antibodies in active group was higher than that in the inactive group and control group,The serum levels of anti-MCV antibodies was positively correlated with the serum level of CRP and IL-6,but not DAS28 by Spearman＇ s test. Anti-MCV with high sensitivity has approximately the same accuracy for the diagnosis of rheumatoid arthritis compared to anti-CCP. Conclusion Anti-MCV antibodies has high sensitivity and specificity. It might indicate the disease activity of RA and may become a valuable marker for the evaluation of RA.