葡萄糖6-磷酸异构酶检测在类风湿关节炎中的意义

为评价葡萄糖6-磷酸异构酶(GPI)在类风湿关节炎(RA)诊断中的价值。检测225例RA患者,77例其他关节炎患者以及80例正常对照血清中GPI、抗环瓜氨酸肽(CCP)抗体和RF-IgM的水平。比较GPI、RF-IgM、抗CCP及GPI和抗CCP联合检测在RA的诊断中的意义,发现:①GPI、RF-IgM、抗CCP敏感性和特异性分别为59.11%、84.71%;77.78%、91.71%;65.33%、94.27%,抗CCP与GPI联合检测可明显提高诊断特异性,对RA诊断的敏感性和特异性分别为45.78%、97.45%;②GPI与抗CCP检测对RF阴性RA病例的诊断有一定价值(14%、26%);③GPI、抗CCP与RF-IgM之间均显著相关(P<0.01);④GPI与病程、功能分级、肿胀关节数、压痛关节数、握力及晨僵持续时间存在相关(P<0.01或P<0.05),而与X线分期、年龄和性别无关(P>0.05)。因之,GPI对RA有较高的诊断价值,CCP和GPI联合检测对RA有高度特异性,GPI能一定程度反映RA的临床病情,可作为RA的血清学指标。

Significance of detection of glucose-6-phosphate isomerase for the diagnosis of rheumatoid arthritis

To evaluate the diagnostic value of detection of glucose-6-phosphate isomerase(GPI) in rheumatoid arthritis(RA),the serum levels of GPI,anti-CCP antibody and RA-IgM in 225 patients with RA,77 patients with other arthritis and 88 healthy individuals were determined by means of double antibody sandwich ELISA,ELISA assay for CCP-IgG and quantitative reagent for detection of RF respectively.It was found that the sensitivities of detecting GPI,anti-CCP antibody and RA-IgM in patients with RA were 59.11%,84.71% and 77.78% respectively,while the specificities of these 3 methods of detection were 91.71%,65.33% and 94.27% respectively.The sensitivity and specificity of the combined detection of GPI and anti-CCP antibody were 45.78% and 97.45% respectively.Significant correlations could be demonstrated among the detections of GPI,anti-CCP antibody and RF-IgM(P<0,01).In addition,level of GPI correlated to certain clinical appearances,such as course of illness,rank of function,numbers of the swollen and tender joints,gripping power and duration of morning stiffness(P<0.01 or P<0.05),but no correlation existed among the clinical stages defined by radiological examinations,sex and age(P>0,05).From these observations,it is evident that the detection of GPI may be a valuable index for the diagnosis of rheumatic arthritis.