类风湿关节炎患者抗环瓜氨酸抗体、HLA—DR4基因与其临床特征的关系

目的 探讨抗环胍氨酸（CCP）抗体、人类白细胞抗原HLA-DR4基因与进展性类风湿关节炎（RA）临床特征的关系.方法 记录73例类风湿关节患者的临床资料和实验室检查结果,并采用细胞毒法检测全部病例的HLA-DR4基因携带情况,比较HLA-DR4阳性组与阴性组的临床表现、实验室指标、X线表现及关节功能分级.结果 HLA-DR4阳性者27例,基因频率为37%.HLA-DR4阳性组关节肿胀指数、疼痛指数较高,晨僵持续时间较长,关节功能分级为Ⅲ～Ⅳ级的比例较高,出现骨质破坏比例也较高,抗CCP抗体、类风湿因子、血沉、C反应蛋白值均高于阴性组.结论 HLA-DR4和抗CCP抗体阳性的RA患者与HLA-DR4阴性组的RA患者比较炎症活动严重,且进展较快,应积极治疗.

The relationship between HLA-DR4 gene and anti-CCP antibody in Hans people of gansu province with progressive rheumatoid arthritis

Objective To investigate the relationship between the genes of human leukocyte antigens（HLA）-DR4 and anti-eep antibody with the clinical characteristics in the progressive rheumatoid arthritis（RA）. Methods We recorded clinical data and related laboratory results of 73 eases rheumatoid arthritis, examined HLA-DR4 gene with cytotoxicity assay, and compared clinical manifestations, laboratory resuhs, X-ray manifestations and joint functional classification. Results HLA-DR4 positive result of 27 cases, the gene frequency was 37%. There was the higher index of joint swelling and pain, the longer duration of morning stiffness ,the higher proportion of bone destruction and joint function Ⅲ～Ⅳ grade level. The value of ESR, CRP and RF, anti-CCP antibody in HLA-DR4 positive group was higher than negative group. Conclusion TSevere inflammatory activity, rapid disease progress, combined treatment should be done in HLA-DR4 positive group.