自身抗体水平与类风湿性关节炎患者机体炎症反应 及骨关节损伤程度的相关性

The Correlations Between the Autoantibody Level and the Inflammatory Reaction and the Degree of Osteoarticular Injury in Rheumatoid Arthritis Patients

目的探讨血清抗Sa抗体、抗环瓜氨酸肽抗体(抗CCP抗体)和抗氨甲酰化蛋白抗体(抗CarP抗体)水平与类风湿性关节炎(RA)患者机体炎症反应及骨关节损伤程度的相关性。方法选取2018年2月至2020年12月在医院接受治疗的137例RA患者作为试验组(活动期105例,稳定期32例),另选取同期120名健康体检者作为对照组,检测并比较两组血清抗Sa抗体、抗CCP抗体、抗CarP抗体、C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、白细胞介素-1β(IL-1β)、类风湿因子(RF)、红细胞沉降率(ESR)、护骨素(OPG)、基质金属蛋白酶3(MMP3)、核因子-κB受体活化因子配体(RANKL)水平,并分析血清抗Sa抗体、抗CCP抗体、抗CarP抗体水平与血清CRP、TNF-α、IL-6、IL-1β、RF、ESR、OPG、MMP3、RANKL水平的相关性。结果试验组血清抗Sa抗体、抗CCP抗体、抗CarP抗体、CRP、TNF-α、IL-6、IL-1β、RF、ESR、OPG、MMP3、RANKL水平均高于对照组,差异有统计学意义(P<0.05);试验组活动期患者血清抗Sa抗体、抗CCP抗体、抗CarP抗体、CRP、TNF-α、IL-6、IL-1β、RF、ESR、MMP3、RANKL水平均高于稳定期患者,血清OPG水平低于稳定期患者,差异有统计学意义(P<0.05);Pearson相关分析显示,RA患者血清抗Sa抗体、抗CCP抗体、抗CarP抗体水平与血清CRP、TNF-α、IL-6、IL-1β、RF、ESR、MMP3、RANKL水平均成正相关(r>0,P<0.05),与血清OPG均成负相关(r<0,P<0.05)。结论相较于健康体检者,RA患者的血清抗Sa抗体、抗CCP抗体及抗CarP抗体水平更高,且其水平与RA患者机体炎症反应及骨关节损伤程度相关,可作为RA诊断、病情评估及预后判断的重要指标。

Objective The correlations between anti-Sa antibody,anti-cyclic citrullinated peptide antibody(anti-CCP antibody)and anti-carbamoylated protein antibody(anti-CarP antibody)levels in serum and the inflammatory reaction and the degree of osteoarticular injury in rheumatoid arthritis(RA)patients were investigated.Methods A total of 137 RA patients treated in the hospital from February 2018 to December 2020 were selected as the experiment group(105 cases in the active stage and 32 cases in the stable stage),and 120 healthy people who underwent physical examination in the same period were selected as the control group.The levels of anti-Sa antibody,anti-CCP antibody,anti-CarP antibody,C-reactive protein(CRP),tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),interleukin-1β (IL-1β), rheumatoid factor (RF), erythrocyte sedimentation rate (ESR), osteoprotegerin (OPG), matrix metalloproteinase-3 (MMP3) and receptor activator of nuclear factor-κB ligand (RANKL) in serum were detected and compared, and then the correlations between anti-Sa antibody, anti-CCP antibody, anti-CarP antibody levels and CRP, TNF-α, IL-6, IL-1β, RF, ESR, OPG, MMP3, RANKL levels in serum were analyzed Results The levels of anti-Sa antibody, anti-CCP antibody, anti-CarP antibody, CRP, TNF-α, IL-6, IL-1β, RF, ESR, OPG, MMP3 and RANKL in serum in the experiment group were all higher than those in the control group, and the differences were statistically significant (P<0.05);the levels of anti-Sa antibody, anti-CCP antibody, anti-CarP antibody, CRP, TNF-α, IL-6, IL-1β, RF, ESR, MMP3 and RANKL in serum in the active phase patients of the experiment group were all higher than those in the stable phase patients, and the OPG level in serum was lower than that in the stable phase patients, and the differences were statistically significant (P<0.05);the Pearson correlation analysis showed that the levels of anti-Sa antibody, anti-CCP antibody and anti-CarP antibody in serum in RA patients were positively correlated with the levels of CRP, TNF-α, IL-6, IL-1β, RF, ESR, MMP3 and RANKL in serum (r>0, P<0.05), and negatively correlated with OPG level in serum (r<0, P<0.05). Conclusion Compared with the healthy subjects, the levels of anti-Sa antibody, anti-CCP antibody and anti-CarP antibody in serum in RA patients are higher, and their levels are related to the inflammatory reaction and the degree of osteoarticular injury in RA patients, which can be used as important indicators for the diagnosis, disease evaluation and prognosis judgement of RA.