早期血清学阴性类风湿关节炎患者实验室和抗体指标的比较

Analysis the clinical characteristics of early serum negative rheumatoid arthritis patients

目的探讨早期血清学阴性类风湿关节炎(RA)患者的临床表现、实验室及影像学特点,为临床诊疗提供参考。方法将病程<2年的RA患者血清学阴性与否分为血清学阴性组(88例)和血清学阳性组(124例),对比2组临床表现、实验室指标及影像学检查的差异。结果早期血清学阴性RA组较血清学阳性组病程相对较短(P<0.05);血清学阴性组RA患者IgA、IgG升高的幅度较阳性组低,血清学阳性组抗核抗体阳性率及抗SSA/SSB、抗Ro52抗体阳性率均高于阴性组(P<0.05);早期RA患者双手X线平片分期比较,血清学阴性组Ⅲ期以上表现者发生率多于血清学阳性组,差异有统计学意义(P<0.05)。结论早期血清学阴性RA患者并不少见,病程相对较短,在疾病早期即可出现免疫紊乱及较为严重的骨侵蚀。

Objective To investigate the clinical manifestations,laboratory and imaging characteristics of early seronegative rheumatoid arthritis(RA)patients,and to provide reference for clinical diagnosis and treatment.Methods According to the course of RA less than 2 years,RA patients were divided into serum negative RA group(88 cases)and serum positive RA group(124 cases).The differences between the two groups were analyzed by comparing the clinical manifestations,laboratory indicators and imaging features.Results Compared with the early serum positive group,the course of the serum negative RA group was relatively shorter(P<0.05).The increase of IgA and IgG in the serum negative group was lower than that in the positive group,and the rate of anti-nuclear antibody,anti-SSA/SSB antibody and anti-Ro52 antibody in the positive group were higher than those in the negative group(P<0.05).Compared with X-ray staging of early RA patients,the incidence of patients with stage III or above in serum negative group was higher than that in serum positive group(P<0.05),and the difference was statistically significant.Conclusions Early seronegative rheumatoid arthritis patients are not uncommon,the course of disease is relatively short.Disorders of the immune system and more severe bone destruction can occur in the early stage of the disease.