类风湿关节炎合并感染患者血清免疫球蛋白和补体检测的意义

目的比较活动期类风湿关节炎(RA)和RA合并感染患者血清免疫球蛋白和补体水平,并探讨免疫球蛋白/补体与RA活动期的关系。方法以70例健康体检者作为对照,80例RA患者根据标准分为静止期组、活动期组和合并感染组,检测所有研究对象血清IgG、IgA、IgM和补体C3、C4的水平,并比较免疫球蛋白和补体与活动期RA和RA合并感染之间的关系。结果 RA活动期患者血清IgG、IgA、显著高于对照组和静止期组,IgM显著高于对照组但不高于静止期。RA活动期与合并感染组免疫球蛋白和补体无显著性差异。IgG、IgA与RA活动期及活动性指标类风湿因子、C反应蛋白、红细胞沉降率高度相关性。结论血清IgG、IgA与RA疾病活动期有相关性,可作为RA活动期的观察指标之一,IgG、IgA、IgM不能作为区分RA活动期和合并感染的指标。补体不能作为判断RA处于合并感染、活动期或静止期的指标。

Significance of Test of Immunoglobulins and Complements in Serum of Patients with Rheumatoid Arthritis Combined with Infection

Objective To compare the difference of the concentration of immunoglobulins(Ig)and complements between active rheumatoid arthritis(RA)and RA combined with infection and explore the relation between Ig/complement and active periods. Methods The serum concentration of IgG,IgA,IgM and complements C3,C4 were detected in 80 patients with rheumatoid arthritis,which were divided into groups of inactive RA,active RA and RA combined with infection.70 age-matched individuals were included as controls.The correlation of Ig/complement in active RA and RA combined with infection were compared.Results The concentration of serum IgG and IgA levels in active rheumatoid arthritis were significantly higher than that in healthy control and inactive RA.The concentration of IgM was significantly higher than that in control but not than inactive RA.However,there was no significant difference between the active RA and RA combined with infection either in Ig or complements.It was highly correlative between IgG,IgA and RF,CRP or ESR.Conclusion Serum IgG,IgA levels can be used as predictive markers for RA activity;IgG,IgA,IgM cannot be used as an indicator of RA active period and combined infection;complements cannot be used as indicator for RA combined infection,RA active period or RA inactive period.