类风湿关节炎患者RF、ANA、CCP、Ig及炎症因子的水平测定及临床意义

目的:探讨类风湿关节炎(RA)患者血清类风湿性因子(RF)、抗核抗体(ANA)、抗环瓜氨酸肽(CCP)抗体、免疫球蛋白(Ig)、补体(C3、C4)以及炎症因子的水平及临床意义。方法:收集2016年9月至2017年4月我院收治的165例RA患者为RA组,其中RA活动期患者93例(RA活动组),RA缓解期患者72例(RA缓解组),并于同期随机选取30例健康体检者为对照组。采用免疫散射比浊法检测各组血清RF、IgM、IgG、IgA、C3、C4水平,采用酶联免疫吸附法(ELISA)检测各组血清CCP抗体,电化学发光法检测白介素-6(IL-6)、化学发光法检测白介素-8(IL-8)。免疫荧光法检测ANA。比较不同组别各检测指标水平,并分析RA患者RF、ANA、CCP抗体、Ig、C3、C4与炎症因子的相关性。结果:RA活动组、RA缓解组血清RF、ANA、CCP抗体、IgM、IgG、IgA、IL-6、IL-8水平高于对照组,且RA活动组血清RF、ANA、CCP抗体、IgM、IgG、IgA、IL-6、IL-8水平高于RA缓解组,差异均有统计学意义(P0.05)。RA活动组、RA缓解组血清C3、C4水平低于对照组,且RA活动组血清C3、C4水平低于RA缓解组,差异均有统计学意义(P0.05)。经Pearson积矩相关分析,RA活动期和缓解期患者血清RF、ANA、CCP抗体、IgM、IgG、IgA与炎症因子IL-6、IL-8呈正相关关系(P0.05),血清C3、C4与炎症因子IL-6、IL-8呈负相关关系(P0.05)。结论:RA患者体内RF、ANA、CCP抗体、Ig及IL-6、IL-8水平明显较高,C3,C4水平明显较低,活动期RA患者更为显著,联合检测可早期辅助诊断RA及判断病情进展,在临床上有重要的参考意义。

Determination and Clinical Significance of Levels of RF, ANA, CCP, Ig and Inflammatory Factors in Patients with Rheumatoid Arthritis

ABSTRACT Objective: To investigate the levels of rheumatoid factor (RF), anti-nuclear antibody (ANA), anti-cyclic citrullonated peptide (CCP) antibodies, immune globulin (Ig), complement (C3, C4) and inflammatory factors in patients with rheumatoid arthritis (RA) and its clinical significance. Methods: A total of 165 patients with RA, who were treated in Affiliated Hospital of Traditional Chinese Medicine of Shanghai University of Traditional Chinese Medicine from September 2016 to April 2017, were chosen as group RA, among which, 93 patients were in the RA active phase (RA active group) and 72 patients were in remission stage of RA (RA remission group). 30 healthy volunteers were randomly chosen as control group in the same period. The serum RF, IgM, IgG, IgA, C3, C4 levels in each group were detected by immune scattering Turbidimetry. CCP antibodies in each group were detected by enzyme linked immunosorbent assay (ELISA). The interleukin-6 (IL-6) was detected by electrochemiluminescence assay, while the interleukin-8 (IL-8) was detected by Chemiluminescence. Immunofluorescence was used to detect ANA. The test indexes of different groups were compared.The correlation of RF, ANA, CCP antibodies, Ig, C3, C4 and inflammatory factors in RA patients was analyzed. Results: The serum RF, ANA, CCP antibodies, IgM, IgG, IgA, IL-6, IL-8 levels of RA active group and RA remission group were higher than those of control group, and the serum RF, ANA, CCP antibodies, IgM, IgG, IgA, IL-6, IL-8 levels of RA active group were higher than those of RA remission group, the differences were statistically significant(P<0.05). The serum C3, C4 levels of RA active group and RA remission group were lower than those of control group, and the serum C3, C4 levels of RA active group were lower than those of RA remission group, the differences were statistically significant (P<0.05). The Pearson product moment correlation analysis showed that serum RF, ANA, CCP antibodies, IgM, IgG, IgA in patients with RA active stage and RA remission stage were positively associated with IL-6, IL-8 (P<0.05), and the serum C3, C4 were negatively associated with IL-6, IL-8 (P<0.05). Conclusion: The RF, ANA, CCP antibodies, Ig and IL-6, IL-8 levels in patients with RA are significantly higher, and C3, C4 levels are significantly lower, especially in patients in RA active stage. Combined detection of RF, ANA, CCP antibodies, Ig, C3, C4 and IL-6, IL-8 can be used in the diagnosis and judgment of RA,which has an important reference significance in clinic.