RF、Ig、ANA与抗ENA抗体检测在类风湿关节炎患者诊断及预后分析中的价值

The role of RF,Ig,ANA and anti-ENA antibody in the diagnosis,treatment and prognosis of patients with rheumatoid arthritis

目的探讨类风湿因子(RF)、免疫球蛋白(Ig)、抗核抗体(ANA)、抗可提取性核抗原多肽(ENA)抗体检测在类风湿关节炎(RA)患者诊断及预后中的价值。方法选取2018年6月至2020年6月该院收治的71例RA患者(RA组)、55例非RA自身免疫性疾病患者(非RA组)为研究对象,并选取30例同期体检健康者作为对照组。RA组患者接受3个月的标准化治疗,根据疗效分为缓解组(n=45)、活动组(n=26)。抽血检测RA组患者治疗前后及非RA组、对照组入院时血清RF、IgA、IgG、IgM、ANA、抗ENA抗体水平。采用受试者工作特征曲线(ROC曲线)分析RF、IgA、IgG、IgM、ANA、抗ENA抗体对RA诊断及预后评估的价值。结果RA组患者血清RF阳性率明显高于非RA组患者及对照组,而血清ANA、抗ENA抗体阳性率虽高于对照组,但明显低于非RA组患者,差异均有统计学意义(P<0.05);RA组患者血清IgA、IgG、IgM水平明显高于非RA组患者及对照组,差异均有统计学意义(P<0.05)。缓解组患者血清RF、ANA、抗ENA抗体阳性率及IgA、IgG、IgM水平均明显低于活动组患者,差异均有统计学意义(P<0.05)。ROC曲线显示,RF、IgA、IgG、IgM、ANA、抗ENA抗体联合检测对RA诊断及预后评估的价值高于各指标单独检测(P<0.05)。结论RF、Ig、ANA与抗ENA抗体检测可用于RA的诊断及预后评估,且当上述指标联合检测时诊断及预后评估价值更高。

Objective To explore the value of rheumatoid factor(RF),immunoglobulin(Ig),anti-nuclear antibody(ANA),and anti-extractable nuclear antigen polypeptide(anti-ENA)antibody detection in the diagnosis,treatment and prognosis of patients with rheumatoid arthritis(RA).Methods The clinical data of 71 RA patients(RA group)and 55 non-RA autoimmune disease patients(non-RA group)from June 2018 and June 2020 were collected retrospectively,and 30 healthy people with normal physical examination during the same period were selected as the control group.Patients in the RA group received 3 months of standardized treatment,and were divided into remission group(n=45)and active group(n=26)according to the efficacy.Blood was drawn to detect serum levels of RF,IgA,IgG,IgM,ANA and anti-ENA antibody before and after treatment in RA group,non-RA group and control group.The receiver operating characteristic curve(ROC curve)was used to analyze the value of RF,IgA,IgG,IgM,ANA and anti-ENA antibody in the diagnosis and prognosis of RA.Results The positive rate of serum RF in the RA group was significantly higher than those of the non-RA group and the control group(P<0.05).Although the positive rate of serum ANA and anti-ENA antibody was higher than that of the control group,it was significantly lower than that of the non-RA group(P<0.05).The serum IgA,IgG and IgM levels of the RA group were significantly higher than that of the non-RA group and the control group(P<0.05).The positive rates of serum RF,ANA and anti-ENA antibody and the levels of IgA,IgG,IgM in the remission group were significantly lower than those in the active group(P<0.05).The ROC curve showed that the value of combined detection of RF,IgA,IgG,IgM,ANA and anti-ENA antibody was higher than the indicators detected separately(P<0.05).Conclusion The detection of RF,Ig,ANA and anti-ENA antibody can be used in the diagnosis and prognosis evaluation of RA,and the diagnosis and prognosis evaluation value is higher when the detection of above indicators are combined.