类风湿性关节炎患者体内抗组蛋白抗体阳性表达情况及影响因素

Positive expression of anti-histone antibody in patients with rheumatoid arthritis and its influencing factors

目的探究类风湿性关节炎(RA)患者体内抗组蛋白抗体(AHA)阳性表达情况及影响因素。方法收集2018年1月至2021年12月在本院确诊的311例RA患者为研究对象。评估患者的AHA阳性表达情况,分析AHA阳性表达与RA患者一般情况、血清指标、滑膜组织炎症、疼痛、骨质侵蚀及疾病活动度的相关性。结果311例RA患者中,AHA阳性68例,阳性率为21.86%。AHA阳性患者的吸烟占比、类风湿因子(RF)阳性率、抗环瓜氨酸肽抗体(ACPA)阳性率及C反应蛋白(CRP)、免疫球蛋白G(IgG)、免疫球蛋白M(IgM)水平高于AHA阴性患者,差异具有统计学意义(P<0.05)。AHA阳性患者的滑膜组织无炎症占比低于AHA阴性患者,滑膜组织重度炎症及骨质侵蚀占比高于AHA阴性患者,差异具有统计学意义(P<0.05)。Logistic回归分析结果显示,吸烟、CRP、滑膜组织炎症、骨质侵蚀是RA患者血清AHA阳性表达的危险因素(P<0.05)。结论部分RA患者可表现出AHA阳性表达,其阳性表达与吸烟、CRP、滑膜组织炎症、骨质侵蚀有关。

Objective To explore the positive expression of anti-histone antibody(AHA)in patients with rheumatoid arthritis(RA)and its influencing factors.Methods A total of 311 RA patients diagnosed in our hospital from January 2018 to December 2021 were collected as the research object.The positive expression of AHA in patients was evaluated,and the correlation between the positive expression of AHA and the general condition,serum indexes,synovial tissue inflammation,pain,bone erosion and disease activity of RA patients was analyzed.Results Among 311 RA patients,AHA was positive in 68 cases,with a positive rate of 21.86%.The smoking proportion,positive rate of rheumatoid factor(RF),the positive rate of anti-cyclic citrullinated peptide antibody(ACPA)and the levels of C-reactive protein(CRP),immunoglobulin G(IgG)and immunoglobulin M(IgM)in AHA positive patients were higher than those in AHA negative patients,and the differences were statistically significant(P<0.05).The proportion of non-inflammation in synovial tissue of AHA positive patients was lower than that of AHA negative patients,and the proportion of synovial tissue severe inflammation and bone erosion were higher than those of AHA negative patients,the differences were statistically significant(P<0.05).Logistic regression analysis showed that smoking,CRP,synovial tissue inflammation and bone erosion were risk factors for serum AHA positive expression in RA patients(P<0.05).Conclusion Some RA patients can show positive expression of AHA,and its positive expression is related to smoking,CRP,synovial tissue inflammation and bone erosion.