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1.
目的:探讨类风湿性关节炎患者的类风湿因子(RF)和白介素-17(IL-17)的表达及临床意义.方法:选取2019年1月~2021年3月我院收治的102例类风湿性关节炎患者为研究组,及102例健康志愿者为对照组.对比两组及不同病情活动程度类风湿性关节炎患者RF、IL-17水平;分析RF、IL-17联合检测对类风湿性关节炎诊断价值.结果:研究组RF、IL-17水平高于对照组(P<0.05).不同病情活动程度类风湿性关节炎患者RF、IL-17水平为:低活动度<中活动度<高活动度(P<0.05).RF、IL-17联合检测的敏感度与特异度均高于单一检测(P<0.05).结论:推测RF、IL-17可能参与了类风湿性关节炎发生、发展过程,联合检测两者在帮助类风湿性关节炎患者进行早期诊断及病情评估具有一定的价值.  相似文献   

2.
目的:研究心肌梗死(MI)患者血管紧张素转换酶(ACE)基因插入/缺失(I/D)多态性与ACE、PAI-1活性的关系。 方法: 应用PCR方法扩增93例MI患者及87例健康体检者ACE基因特异性片段,同时应用比色法测定血清ACE活性,发色底物法测定PAI-1活性,并对结果进行相关性分析。 结果:①MI组ACE DD基因型频率(32.3%)和D等位基因频率(54.3%)显著高于对照组(12.6%和37.4%)(均P<0.01)。②MI组血清ACE(216.00±58.26)U/L及血浆PAI-1活性(0.85±0.19)AU/mL均显著高于对照组(170.19±48.99)U/L, (0.66±0.20)AU/mL(均P<0.01);MI组与对照组ACE与PAI-1活性均呈显著正相关(r分别为0.7108,0.7829,均P<0.01);③MI组DD基因型血清ACE(251.64±57.76)U/L、血浆PAI-1活性(0.96±0.16)AU/mL显著高于ID基因型(211.47±51.87)U/L,(0.82±0.18)AU/mL及Ⅱ基因型(179.84±52.65)U/L,(0.71±0.17)AU/mL(均P<0.01);ID基因型血清ACE、血浆PAI-1活性亦显著高于Ⅱ型(P<0.05)。对照组DD基因型血清ACE(195.53±54.76)U/L、血浆PAI-1活性(0.78±0.20)AU/mL,显著高于II基因型(154.98±52.74)U/L,(0.59±0.17)AU/mL(均P<0.05)。 结论:由ACE基因所决定的ACE活性,可能参与血浆PAI-1水平的调节;ACE基因I/D多态性与ACE、PAI-1水平相关,ACE基因种类影响纤溶平衡,这可能是其促使MI发病的重要机制之一。  相似文献   

3.
目的 探讨甲氨蝶呤(MTX)治疗大鼠类风湿关节炎(RA)的疗效及对抗环瓜氨酸肽抗体(ACCP)、类风湿因子(RF)的影响.方法 选择60只SD大鼠建立类风湿关节炎模型,并随机分为对照组、模型组和治疗组.治疗组大鼠每周给予甲氨蝶呤灌胃3.8 mg/kg,连续6周.大鼠关节炎评分和足趾容积的测定RA疾病程度;苏木精-伊红(HE)染色和甲苯胺蓝染色检测类风湿关节炎的病理改变程度;ELISA检测组织中ACCP、RF、TNF-α,IL-1β和IL-17水平的表达;Western blot检测RANKL和OPG蛋白表达.结果 随着实验时间的延长,治疗组大鼠体质量于实验第4周和第6周明显高于模型组(P<0.05);治疗组大鼠关节炎评分和足趾容积明显低于模型组(P<0.05).与模型组比较,治疗组RANKL蛋白含量显著降低,OPG蛋白含量明显上升(P<0.05);治疗组ACCP和RF含量显著降低,TNF-α、IL-1β和IL-17含量明显下降(P<0.05).结论 甲氨蝶呤治疗大鼠类风湿关节炎具有较好的疗效,且能抑制细胞因子的表达,降低ACCP、RF水平.  相似文献   

4.
目的:甲氨蝶呤联合艾拉莫德治疗类风湿性关节炎患者的临床疗效及预测研究.方法:时间为2019年9月~2020年5月,研究对象为我院收治的类风湿性关节炎患者104例,随机分为对照组(n=52)和研究组(n=52).对比两组临床疗效、实验室指标[C-反应蛋白(C-reactive protein,CRP)、类风湿因子(rheumatoid factors,RF)、红细胞沉降率(erythrocyte sedimentation rate,ESR)];疗效预测因素分析.结果:研究组总有效率(96.15%)高于对照组(82.69%)(P<0.05);两组治疗后ESR、CRP、RF水平均降低,以研究组最显著(P<0.05).经Logistic回归模型分析得:年龄(>60岁)、肿胀关节数(>5处)是类风湿性关节炎患者临床疗效的影响因素(P<0.05).结论:甲氨蝶呤与艾拉莫德联合治疗类风湿性关节炎疗效确切,可有效改善患者的ESR、CRP、RF水平.  相似文献   

5.
血清胞苷脱氨酶在活动性类风湿关节炎诊疗中的意义   总被引:1,自引:0,他引:1  
目的:探讨测定血清胞苷脱氨酶(CD)含量对活动性类风湿关节炎(RA)患者的诊疗价值。方法:采用分光光度法测定血清中的胞苷脱氨酶活性,同时用免疫比浊法测定C反应蛋白(CRP),魏氏法测定血沉(ESR)。结果:活动性RA组血清CD含量(14.80±2.11)U/m l,显著高于正常对照组(4.86±1.86)U/m l,(P<0.01);CRP(51.46±20.43)mg/L和ESR(85.03±27.6)mm/1h明显高于正常对照组(3.40±2.21)mg/L,(13.04±4.89)mm/1h(均P<0.01);活动性RA患者组CD含量与ESR、CRP成直线关系,相关系数r分别为0.6324(P<0.01)与0.8013(P<0.01)。结论:血清CD活性可作为活动性RA患者急性感染的早期诊断指标,对活动性RA患者的预后判断亦有临床价值。  相似文献   

6.
目的:探究类风湿性关节患者采用AKA结合RF检测的诊断效果.方法:选择本院自2020年1月至2022年10月间收诊的202例类风湿性关节炎(Rheumatoid Arthritis,RA)患者作为研究组研究对象,再另选103例其他自身免疫系统疾病患者作为对照组研究对象,比较两组抗角蛋白抗体(Anti-keratin Antibody,AKA)、类风湿因子(Rheumatoid Factor,RF)指标情况及AKA、RF的诊断效能.结果:研究组AKA、RF指标明显高于对照组(P<0.05);对照组AKA阳性率为11.65%(12/103)、RF诊断阳性率为22.33%(23/103)、AKA联合RF诊断阳性率为1.94%(2/103);研究组AKA阳性率为87.13%(176/202)、RF诊断阳性率为85.64%(173/202)、AKA联合RF诊断阳性率为95.05%(192/202);且研究组AKA诊断、RF诊断的阳性率明显低于AKA联合RF诊断(P<0.05);单项AKA检测的准确率等相关效能分别为83.54%、75.14%、84.42%、81.33%、82.54%;单项RF检测的准确率等诊断效能分别为82.33%、87.91%、76.63%、83.49%、80.54%;AKA联合RF诊断的准确率等相关效能分别为91.32%、96.44%、92.73%、94.57%、93.27%;联合检测各项诊断效能明显高于各单项检测(P<0.05).结论:AKA检测与RF检测对RA患者均有一定的诊断价值,两种指标联合检测能进一步提高RA的诊断效果,为RA早期预测提供理论支持.  相似文献   

7.
目的 通过检测类风湿性关节炎(RA)患者血清中细胞因子白细胞介素(IL)-37、肿瘤坏死因子-α(TNF-α)、IL-18、炎性指标红细胞沉降率以及C-反应蛋白(C-reactionprotein,CRP)水平,观察RA患者临床数据包括压痛关节数,肿胀关节数以及DAS28评分等,探讨RA患者血清IL-37水平升高的意义以其在RA发病机制中可能的作用.方法 80例RA患者、80例健康对照患者,通过酶联免疫吸附试验(ELISA)法检测其血清中细胞因子水平.结果 RA患者血清中IL-37[(40.33±11.25)pg/mL]、TNF-α[(110.41 ±35.37) pg/mL]、IL-18[(121.73±29.22) pg/mL]水平以及红细胞沉降率(ESR)[(42.31±15.02) mm./h]、CRP[(38.31±17.22) mg/L]水平明显高于对照组IL-37[(18.21±5.72) pg/mL]、TNF-α[(30.19±6.82) pg/mL]、IL-18[(55.47±7.29) pg/mL]水平,组间差异有统计学意义(P<0.05).IL-37的表达与TNF-α、IL-18水平呈正相关(相关系数r=0.981,P=0.001).结论 IL-37在RA患者体内高表达并与其它几种炎性因子的表达具有相关性,IL-37可能作为炎性抑制因子参与了RA的发生、发展.  相似文献   

8.
类风湿性关节炎患者血清抗Ⅱ型胶原抗体的检测及意义   总被引:3,自引:0,他引:3  
目的探讨类风湿性关节炎(RA)患者血清抗Ⅱ型胶原(CⅡ)抗体阳性的意义. 方法分别以人Ⅱ型胶原蛋白(HCⅡ)及牛Ⅱ型胶原蛋白CⅡ(BCⅡ)作为包被抗原进行间接 ELISA法,检测30例RA患者,对照组(30例非RA的风湿病患者和34例健康人)血清抗CⅡ抗体. 结果以HCⅡ及BCⅡ作为包被抗原检测RA患者血清抗CⅡ抗体的阳性率分别约为30.0%和33.3%;对照组血清中抗体阳性率均约为1.6%;二者差异极其显著(P<0.01).抗CⅡ抗体阳性的RA患者RF的阳性率高于抗CⅡ抗体阴性的RA患者.与HCⅡ和BCⅡ均发生阳性反应的血清8例,均为早期RA患者. 结论抗CⅡ抗体可作为判断RA患者病情的辅助手段之一,牛CⅡ可替代人CⅡ进行有关RA发病机制中B细胞免疫的实验研究.  相似文献   

9.
抗环瓜氨酸肽抗体在类风湿性关节炎诊断中的应用   总被引:7,自引:0,他引:7  
目的 探讨抗环瓜氨酸肽 (CCP)抗体检测在类风湿性关节炎 (RA)诊断中的意义。方法 根据cDNA序列人工合成的CCP为抗原 ,用ELISA方法检测 2 18例 (RA 112例 ,非RA 76例及正常人 30例 )血清中的抗CCP抗体 ,并比较抗CCP抗体与类风湿因子 (RF)的相关性。结果 抗CCP抗体在RA组患者血清中的阳性率 4 9.1% ,明显高于非RA组 ( 3.94 % )和正常对照组 ( 0 .0 % ) ,经 χ2 检验P <0 .0 5。抗CCP抗体对诊断RA的敏感性和特异性分别为 4 9.1%、96 .1% ,阳性预测值和阴性预测值为 94 .8%、4 3.8%。在 112例确诊为RA患者的血清中抗CCP抗体与RF重叠阳性率为 85 .4 % ,两者含量呈正相关。结论 抗CCP抗体对RA具有很高的特异性 ,可视为新的RA血清学诊断指标  相似文献   

10.
目的:探讨不同糖皮质激素应用途径治疗类风湿关节炎对患者肺部感染的影响。方法:2013 年1 月至2017年2 月选择在我院诊治的RA 患者128 例作为研究对象,根据随机信封抽签原则分为观察组与对照组各64 例,观察组给予关节腔注射糖皮质激素治疗,对照组给予口服糖皮质激素治疗,两组都治疗观察8 周。结果:观察组与对照组的治疗总有效率分别为96.9%和84.4%,观察组的治疗总有效率明显高于对照组(P<0.05)。观察组与对照组治疗后的关节疼痛与关节肿胀指数都明显低于治疗前(P<0.05),同时治疗后观察组的关节疼痛与关节肿胀指数也明显低于对照组(P<0.05)。观察组与对照组的肺部感染发生率分别为1.6%和7.8%,观察组的肺部感染发生率明显低于对照组(P<0.05)。观察组治疗后的CRP 与RF 值分别为(10.11±3.19)mg/ L 和(50.22±19.82)U/ ml,都明显低于对照组的(17.49±5.32)mg/ L 和(59.14±20.59)U/ ml(P<0.05),同时两组治疗后的CRP 与RF 值都明显低于治疗前(P<0.05)。结论:相对于口服治疗,关节腔内注射糖皮质激素治疗RA 能降低肺部感染发生率,抑制炎症因子与RF 表达,促进缓解临床症状,从而提高治疗效果。  相似文献   

11.
Occurrence of autoantibodies in patients' sera is the characteristic feature of autoimmune disorders. We assessed the presence of anti-mannose binding lectin (MBL) autoantibodies in the sera of 107 rheumatoid arthritis (RA) patients and 121 control subjects by enzyme immunoassay. Elevated levels of anti-MBL autoantibodies in the sera of RA patients (P<0.0001) was detected for the first time. The ratios of anti-MBL positive in RA patients and controls were respectively 60.7% and 1.65%. Experiments were then designed to understand the functional relevance of these autoantibodies. An inverse correlation of anti-MBL autoantibodies with serum MBL levels (P=0.001) and MBL complex activity (P=0.02) was observed without genetic association between MBL polymorphisms and anti-MBL autoantibody secretion. A significant increase (P=0.038) in the level of anti-MBL autoantibodies was observed in 23 synovial fluid samples in comparison to the serum samples. Moreover, the anti-MBL autoantibodies were found to be more often present in the sera of RA patients (60.75% sensitivity, 98.35% specificity and 0.913 area under the ROC curve) in comparison to the IgM and IgG isotypes of rheumatoid factors (RF). Anti-MBL autoantibodies were still positive in 25.23% RA patients when both the RF isotypes were negative. Also, in RA patients, at all stages of disease activity and joint deformity, anti-MBL autoantibodies were more often present than both the RF isotypes. Therefore, the significant presence of anti-MBL autoantibodies enunciates that anti-MBL autoantibodies might have a diagnostic value; however, more studies are needed to confirm the role of anti-MBL autoantibodies in the diagnosis of rheumatoid arthritis.  相似文献   

12.
Approximately one-third of rheumatoid arthritis (RA) patients are seronegative for the 2 serological RA markers, rheumatoid factor (RF) and antibodies against cyclic citrullinated peptides (ACCP). Moreover, the sensitivities of both markers are lower in the diagnostically important early disease phase. The aim of this study was to identify additional autoantibody markers for early RA and for RF-negative, ACCP-negative (seronegative) RA.We screened an RA synovium cDNA phage display library with autoantibodies in plasma from 10 early (symptoms of maximum 1 year) and 10 seronegative (RF-negative, ACCP-negative) RA patients with validation in 72 additional RA patients and 121 controls (38 healthy controls, 43 patients with other inflammatory rheumatic diseases, 20 osteoarthritis patients and 20 subjects with mechanical joint complaints). Fourteen novel autoantibodies were identified that showed a 54% sensitivity and 90% specificity for RA. For 11 of these autoantibodies, an exclusive presence was demonstrated in RA patients (100% specificity, 37% sensitivity) as compared to controls. All early RA patients were positive for at least one of the identified autoantibodies and antibody-positivity was associated with a shorter disease duration (P = 0.0087). 52% of RA patients who initially tested negative for RF and ACCP, tested positive for at least one of the 14 novel autoantibodies, resulting in a 19% increase in sensitivity compared to current serological testing. Moreover, 5 identified autoantibodies were detected more frequently in seronegative RA patients, indicating that these autoantibodies constitute novel candidate markers for this RA subtype. We demonstrated that the targets of 3 of these 5 autoantibodies had an increased expression in RA synovial tissue compared to control synovial tissue, pointing towards a biological rationale for these auto antibody targets in RA.In conclusion, we identified novel candidate autoantibody markers for RA that can be detected in early and seronegative RA patients indicating the potential added value for RA diagnostics.  相似文献   

13.
为评估类风湿因子(rheumatoid factor,RF)、抗环瓜氨酸肽(cyclic citrullinated pepdide,CCP)抗体、抗Sa抗体和抗角蛋白抗体(anti-keratin antibody,AKA)自身抗体对类风湿关节炎(rheumatoid arthritis,RA)诊断的意义,采用速率散...  相似文献   

14.
Our objective was to evaluate the prevalence of autoantibodies to cyclic citrullinated peptides (anti-CCP aAbs) in a cohort of patients with a variety of inflammatory or non-inflammatory rheumatic diseases other than rheumatoid arthritis (RA). Six hundred and nine serum samples were tested for anti-CCP aAbs and for rheumatoid factor (RF) using enzyme-linked immunosorbent assays and immunonephelometry. The prevalence of anti-CCP aAbs and RF reached 10% and 25%, respectively, using the positive cutoff value suggested by the manufacturers. Using a higher cutoff value (50 U/ml) for both aAbs, the prevalence was lower with 6% and 16%, respectively. The specificity of both markers for RA thus reached 94% and 84%, respectively. Anti-CCP aAbs were found to be elevated in inflammatory and also in non-inflammatory rheumatic diseases in the same proportion. Clinical data obtained for 36 positive patients showed that 17% developed RA within 5 years. In conclusion, anti-CCP aAbs are clearly more specific than RF for RA. Follow-up of anti-CCP aAbs-positive patients with inflammatory or non-inflammatory rheumatic diseases other than RA could be important considering the predictive value of these aAbs for the development of RA.  相似文献   

15.
The recent identification of tissue transglutaminase (tTG) as the autoantigen for celiac disease-associated anti-endomysial antibodies (EMA) has allowed the use of rapid immunoassay to detect the presence of autoantibodies, anti-tTG, in the serum of patients. In this study, we examined the prevalence of IgG or IgA anti-tTG in sera from patients with elevated levels of IgM rheumatoid factors, which are autoantibodies reactive with the Fc portion of IgG. We report here on four cases of anti-tTG positivity for patients with elevated IgM rheumatoid factor (RF) without evidence of celiac sprue. The study population consisted of 65 patients (26 men, 39 women; mean age, 49 years; range 4 - 92 years) with elevated RF (>20 U/ml ), and 23 healthy subjects (12 men, 11 women; mean age, 46 years; range, 21 - 54 years). IgG and IgA anti- tTG levels were detected using a commercially available ELISA kit (Immuno-Biological Laboratories, Germany). Out of 65 patients, one (1.5%) and three (4.6%) patients were positive for IgG and IgA anti-tTG antibodies, respectively, and this was a higher frequency than occurred in healthy subjects (0/23). The clinical features of the four cases positive for IgG or IgA anti-tTG were as follows: The first case (female, 63 yrs) positive for IgA anti-tTG antibody suffered from rheumatoid arthritis, type II diabetes mellitus, iron deficiency anemia and gastric indigestion without symptoms of malabsorption. She denied any gluten sensitivity on her diet. Her esophagogastroduodenoscopic biopsy showed mucosal atrophy with no elongated crypts or infiltration of inflammatory cells in the lamina propria. The remaining three cases positive for anti-tTG antibodies had interstitial pneumonia, a herniated lumbar disc, and mild scoliosis, respectively. They all denied any malabsorption symptoms or gluten sensitivity. Jejunal biopsy could not be performed in all four cases.  相似文献   

16.

Objective

The aim of our study was to investigate the contribution of serum calreticulin (CRT) in the assessment of disease activity in rheumatoid arthritis (RA).

Methods

Serum CRT levels were measured by ELISA in 70 patients with established RA, 30 systemic lupus erythematosus (SLE), 25 other autoimmune diseases, 20 osteoarthritis (OA), and 35 of healthy controls (HC). Correlations of CRT serum levels with disease activity [Disease Activity Score for 28 joints (DAS28)], erythrocyte sedimentation rate(ESR) and C-reactive protein (CRP) were assessed. Serum CRT levels were also detected in RA patients whose RF, anti-CCP and anti- MCV antibodies were positive and negative.

Results

Serum CRT levels in RA patients (4.817?±?2.425 ng/ml) was significantly higher (P <0.05) compared with those in the serum of OA (3.574?±?0.942 ng/ml), SLE (4.013?±?1.536 ng/ml), other autoimmune diseases (3.882?±?0.837 ng/ml) and HC (3.726?±?0.627 ng/ml). Significant positive correlation of CRT with DAS28, ESR and CRP was found in RA patients. Furthermore, RA patients whose anti-CCP and anti-MCV antibodies were positive had higher levels of CRT (P?<?0.01).

Conclusion

Serum CRT levels were increased in patients with RA compared with those controls. Moreover, a significant correlation was observed between serum CRT levels and disease activity in RA. It might be used as a potential biomarker for clinical diagnosis and provide additional information regarding disease activity along with the traditional indices such as ESR and CRP.  相似文献   

17.
Aim:  The aim of this study is to examine the diagnostic value of autoanitbodies in patients suffering from rheumatoid arthritis. We evaluated the presence of the following autoantibodies: rheumatoid factor (RF), antinuclear antibodies (ANAs), antibodies against cadiolipin (a-CL) and antibodies against cyclic citrullinated peptide (anti-CCP).
Methods:  We studied the presence of RF, ANA, a-CL and anti-CCP in 40 patients with rheumatoid arthritis. Rheumatoid factor was measured using nephelometric method, while ANAs were examined by indirect immunofluorescence technique using Hep-2 cells as substrate. Sera that reacted at 1/80 dilution were classified as ANA positive. Positive sera were studied up to 1/1280 dilution. A-CL and anti-CCP were measured by enzyme-linked immunosorbent assay.
Results:  RF was positive in 30 patients (75%), ANA in 15 (37%), a-CL in 10 (25%) and anti-CCP in 36 (90%). Predominant pattern of nuclear staining of ANA-positive sera was homogenous and speckled type. ANA titres were particularly low; most patients (6) had ANA titre equal to 1/80, and five patients had a titre of 1/160, while only four out of 40 had an ANA titre of 1/320.
Conclusions:  Autoimmune disorders such as RA are characterized by various autoantibodies that usually are not specific, as they are present in many other diseases. However, RF and especially anti-CCP are very often and show higher specificity for RA, being useful diagnostic serological markers. On the other hand, ANA and a-CL are less common in RA paitents; they may be useful in terms of prognosis and treatment, but they always should be evaluated in correlation with the clinical features and the rest of the laboratory findings of each patient.  相似文献   

18.
OBJECTIVES: to evaluate specificity and sensibility of the rheumatoid factors (RF), the anti-cyclic citrullinated peptide antibodies (CCP) and the anti-keratin antibodies (AKA) according to the rheumatoid arthritis (RA) diagnosis; pathology other than RA with at least one of these marker positive; the significance of the flocculent fluorescence of the antibodies AKA by indirect immunofluorescence (IIF). METHOD: two hundred forty height patients were studied: 121 RA, 89 inflammatory rheumatisms, 23 non inflammatory rheumatisms, and 15 non rheumatic affections. The RF was investigated by nephelometry, the anti-CCP by immunofluorometry and the AKA by IIF on rat oesophagus. RESULTS: specificity and sensibility were respectively in a retrospective manner: 68% and 83% for the RF, 95% and 76% for the anti- CCP, 83% and 40% for the AKA during RA with evolution of less than one year. The rates of agreements were: RF versus CCP: 81%, RF versus AKA: 57%, CCP versus AKA: 73%. Twelve patients with pathologies different from RA have positive anti-CCP or AKA. Thirty three of the patients with anti-CCP level superior to 130 U/mL have flocculent AKA versus only 5% when the anti-CCP are lower than 130 U/mL. CONCLUSION: the RF and the anti-CCP are complementary in RA. Autoimmune and neoplasic pathologies are sometimes responsible for the positivity of the anti-CCP and the AKA. The flocculent aspect of AKA in IIF may be associated with raised concentrations of anti-CCP.  相似文献   

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