免疫球蛋白及抗CCP抗体在类风湿性关节炎病理进展中变化及临床价值

目的分析类风湿性关节炎(RA)疾病特点,评价免疫球蛋白免疫球蛋白A(IgA)、免疫球蛋白G(IgG)、免疫球蛋白M(IgM)]、抗血清抗环瓜氨酸肽(CCP)抗体在RA病理进展中的诊断价值。方法选取80例RA患者作为观察组,另选取同期健康体检者80例作为对照组;观察组RA患者根据28个关节疾病活动度评分(DAS28评分)分为高度组(>5.1分,15例)、中度组(3.2~5.1分,25例)、低度组(2.6~3.1分,20例)以及缓解组(<2.6分,20例)。测定所有受检者血清中抗CCP抗体、免疫球蛋白(IgA、IgG、IgM)水平。比较观察组和对照组血清免疫指标(抗CCP抗体、IgA、IgG、IgM)水平,不同活动度RA患者免疫指标水平。结果观察组患者的抗CCP抗体、IgA、IgG、IgM水平分别为(64.50±19.80)U/ml、(4.70±0.99)g/L、(18.28±5.05)g/L、(4.06±1.02)g/L,均高于对照组的(8.80±2.30)U/ml、(1.28±0.45)g/L、(10.58±3.58)g/L、(1.18±0.40)g/L,差异具有统计学意义(P<0.05)。高度组、中度组、低度组以及缓解组患者的血清抗CCP抗体、IgA、IgG、IgM水平均呈降低趋势,且组间两两比较差异具有统计学意义(P<0.05)。结论RA患者血清中免疫球蛋白、抗CCP抗体水平升高明显,与病情活动度关系密切,是RA疾病早期诊治的主要监测指标。

Changes and clinical value of immunoglobulin and anti-CCP antibody in the pathological progression of rheumatoid arthritis

Objective To analyze the characteristics of rheumatoid arthritis(RA),evaluate the diagnostic value of immunoglobulinimmunoglobulin A(IgA),immunoglobulin G(IgG),immunoglobulin M(IgM)],antiserum anti-cyclic citrullinated peptide(CCP)antibodies in the pathological progression of RA.Methods There were 80 RA patients selected as the observation group,and anther 80 healthy subjects as the control group.According to the disease activity score of 28 joints(DAS28 score),the RA patients in the observation group were divided into high group(>5.1 points,15 cases),moderate group(3.2-5.1 points,25 cases),low group(2.6-3.1 points,20 cases)and remission group(<2.6 points,20 cases).The levels of anti-CCP antibodies and immunoglobulins(IgA,IgG,IgM)in the serum of all subjects were determined.The levels of serum immune indexes(anti-CCP antibody,IgA,IgG,IgM)in the observation group and the control group were compared.Results The anti-CCP antibody,IgA,IgG,IgM levels of the observation group were(64.50±19.80)U/ml,(4.70±0.99)g/L,(18.28±5.05)g/L and(4.06±1.02)g/L,which were all higher than(8.80±2.30)U/ml,(1.28±0.45)g/L,(10.58±3.58)g/L and(1.18±0.40)g/L of the control group,and the difference was statistically significant(P<0.05).The levels of serum anti-CCP antibody,IgA,IgG,and IgM of patients in the high,moderate,low and remission groups showed a decreasing trend,and the difference between every two groups was statistically significant(P<0.05).Conclusion The serum levels of immunoglobulin and anti-CCP antibody antibody in RA patients are significantly increased,which are closely related to the disease activity and are the main monitoring indicators for the early diagnosis and treatment of RA.