类风湿因子IgM-RF、IgG-RF、IgA-RF及血清IL-6对类风湿关节炎的早期诊断意义

Early diagnosis of rheumatoid arthritis by rheumatoid factors IgM-RF, IgG-RF, IgA-RF and serum IL-6.

目的 探究类风湿因子(RF)IgM-RF、IgG-RF、IgA-RF以及血清白细胞介素-6(IL-6)对类风湿关节炎(RA)的早期诊断意义。方法 回顾性选取2020年1月至2022年10月湖北民族大学附属民大医院接收的RA患者80例作为RA组,选取非自身免疫性疾病患者53例作为非RA组,同时选取健康体检者50名作为对照组。根据所有患者的临床就诊资料统计对比其一般资料、血清RF表达以及IL-6浓度;采用Logistics回归分析血清RF表达及血清IL-6浓度对RA影响因素;采用受试者工作特征(ROC)曲线分析血清RF表达及血清IL-6浓度对RA的诊断价值。结果 3组患者的一般资料比较,差异均无统计学意义(P>0.05),RA组患者外周血IgM-RF、IgG-RF、IgA-RF、抗核抗体阳性检出率均高于非RA组、对照组,同时血清IL-6浓度也高于非RA组和对照组,差异均有统计学意义(P<0.05)。Logistics分析显示,3种RF指标、外周血IL-6高表达是RA发病的独立危险因素(P<0.05),抗核抗体影响不显著(P>0.05)。ROC分析显示,IgM-RF、IgG-RF、IgA-RF和血清IL-6联合诊断RA的AUC最高,为0.905(95%CI:0.853~0.944)。结论 类风湿因子IgM-RF、IgG-RF、IgA-RF联合血清IL-6对RA早期患者具有较高的诊断价值,值得临床重视。

Objective To investigate the significance of IgM-RF,IgG-RF,IgA-RF and serum interleukin-6(IL-6)in the early diagnosis of Rheumatoid arthritis(RA).Methods From January 2020 to October 2022,80 patients with RA admitted to Hubei Minzu University Affiliated Minda Hospital were retrospectively selected in this study and counted as RA group.At the same time,53 patients with non-autoimmune diseases were selected as non-RA group,and fifty healthy subjects were selected as the control group.According to the clinical data of all patients,the general data,the influence factors of serum RF expression and serum IL-6 concentration on RA were analyzed using logistic regression;the diagnostic value of serum RF expression and serum IL-6 concentration for RA was analyzed using the receiver operating characteristic(ROC)curve.Results There was no statistically significant difference in the general data among the three groups of patients(P>0.05).The positive detection rates of IgM-RF,IgG-RF,IgA-RF and antinuclear antibody in peripheral blood of patients in RA group were higher than those in non RA group and control group,and the serum IL-6 concentration was also higher than that in non RA group and control group,the differences were statistically significant(P<0.05).Logistics analysis showed that three RF indexes and high expression of IL-6 in peripheral blood were independent risk factors for RA(P<0.05),while ANA had no significant effect(P>0.05).ROC analysis showed that the AUC of IgM-RF,IgG-RF,IgA-RF and serum IL-6 in the diagnosis of RA was the highest,which was 0.905(95%CI:0.853-0.944).Conclusion Rheumatoid factors IgM-RF,IgG-RF and IgA-RF combined with serum IL-6 have high diagnostic value in early RA patients,and deserve clinical attention.