抗角蛋白抗体在老年类风湿关节炎中检测意义

Antikeratin Antibody in Elderly-onset Rheumatoid Arthritis

目的 :了解抗角蛋白抗体 (AKA)对老年类风湿关节炎 (EORA)诊断意义。方法 :以 Wistar大鼠中 1/ 3食管组织冰冻切片为底物 ,采用间接免疫荧光法检测 5 1例 EORA及 13 9例对照组的血清 AKA,记录同期临床及实验室指标。结果 :AKA对 EORA诊断敏感性 3 1.4% ,特异性 98.6%。早期 EORA患者 AKA阳性率 2 8.6%。 AKA阳性组 Ig M、ESR较阴性组高 ;医生及患者对病情活动性评分、Sharp评分有增高趋势。 16例 AKA阳性 EORA中 ,RF、APF、抗 Sa抗体阳性数分别为 11例、15例和 4例 ,AKA与 APF相关。结论 :AKA有助于 EORA诊断及早期诊断 。

Objective To learn the diagnostic significance of antikeratin antibody(AKA) in patients with elderly onset rheumatoid arthritis (EORA).Methods 51 patients with EORA and 139 cases of the control were assayed for AKA with indirect immunofluorescene technique by using the middle third of Wistar rat esophagus as antigen substrate. ESR, IgM, patient's and physician's global assessment of disease activity, modified Sharp's radiological progression scores, RF, antiperinuclear factor and anti Sa antibody were compared between AKA positive and negative EORA patients. Results At the titer of 1∶20, AKA was detected in 31.4 % of EORA patients, the diagnostic specificity was 98.6 %. The positive rate of AKA in early EORA was 28.6 %. ESR and IgM in AKA positive cases were significantly higher than those in negative ones. There were no significant differences in patient's and physician's global assessment of disease activity, modified Sharp's radiological progression scores, RF, antiperinuclear factor and anti Sa antibody between the AKA positive and negative patients. There were 11 cases with RF, 15 with APF, 4 with anti Sa antibody in 16 AKA positive EORA patients. AKA was associated with APF. Conclusion AKA is a valuable diagnostic tool for EORA, especially for early EORA. It might be one of disease activity and prognostic marker for EORA.