抗氨甲酰蛋白抗体与类风湿性关节炎的相关性分析

Relationship between anti-carbamylated protein antibody and rheumatoid arthritis

目的分析类风湿性关节炎(RA)患者血清中抗氨甲酰蛋白(Carp)抗体水平,探讨其对RA的诊断和评估意义。方法采用酶联免疫吸附试验(ELISA)检测RA组(102例)、非RA组(55例)及健康对照组(83名)血清抗Carp Ig G抗体、抗Carp Ig A抗体水平,分析这2个指标在3组间的差异及其与RA患者其他相关实验室指标的关系。结果 RA患者血清抗Carp Ig G抗体的水平为(8.60±2.64)U/L,阳性率为42.16%,抗Carp Ig A抗体的水平为(6.65±3.09)U/L,阳性率为46.08%,均高于非RA组和健康对照组(P<0.05)。抗环瓜氨酸肽(CCP)阴性的RA患者抗Carp Ig G抗体的阳性率为46.67%,抗Carp Ig A抗体的阳性率为33.33%。抗Carp Ig G抗体阳性组Ig G、Ig A和Ig M水平与抗Carp Ig G抗体阴性组比较,差异有统计学意义(P<0.05);抗Carp Ig A抗体阳性组Ig G、Ig A、Ig M和补体(C)4水平明显高于抗Carp Ig A抗体阴性组(P<0.05)。抗Carp Ig G抗体与抗CCP抗体和类风湿因子(RF)均无明显相关性(P>0.05),抗Carp Ig A抗体与抗CCP抗体和RF也无明显相关性(P>0.05)。结论抗Carp抗体是一种新的对RA有诊断价值的血清学指标,与疾病严重程度相关,特别是其对于抗CCP抗体阴性RA的临床意义值得进一步研究。

Objective To analyze the level of anti-carbamylated protein （Carp） antibody in patients with rheumatoid arthritis （RA）,and to investigate the role of anti-Carp antibody in the diagnosis and evaluation of RA. Methods The levels of serum anti-Carp IgG and anti-Carp IgA antibodies in RA group （102 cases）,non-RA group （55 cases） and healthy control group （83 cases） were determined by enzyme-linked immunosorbent assay（ELISA）. The difference of the 2 indices among the 3 groups and the relationship between anti-Carp antibody and RA were evaluated. Results The level of anti-Carp IgG antibody in serum of RA group was （8.60±2.64）U/L,and the positive rate was 42.16%. The level of anti-Carp IgA antibody in serum of RA group was （6.65±3.09）U/L,and the positive rate was 46.08%,which were higher than those in non-RA group and healthy control group （P〈0.05）. The positive rate of anti-Carp IgG antibody was 46.67%,and the positive rate of anti-Carp IgA antibody was 33.33% in anti-cyclic citrullinated peptide （CCP） antibody negative RA patients. The levels of IgG,IgA and IgM in anti-Carp IgG antibody positive group had statistical significance compared with those in anti-Carp IgG antibody negative group （P〈0.05）,and the levels of IgG,IgA,IgM and complement （C）4 in anti-Carp IgA antibody positive group were higher than those in anti-Carp IgA antibodynegative group （P〈0.05）. There was no correlation of anti-Carp IgG antibody with anti-CCP antibody and rheumatoid factor（RF） （P〉0.05）,and there was no correlation of anti-Carp IgA antibody with anti-CCP antibody and RF （P〉0.05）. Conclusions Anti-Carp antibody is a new serological marker for the diagnosis ofRA,and it may be associated with the severity of the disease,which may contribute to the diagnosis of anti-CCP antibody negative RA.