老年类风湿关节炎患者抗角蛋白抗体检测意义

目的：了解抗角蛋白抗体（AKA）对老年类风湿关节炎（EORA）的诊断意义。方法：以Wistar大鼠中1／3食管组织冰冻切片为底物，采用间接免疫荧光光检测51例EORA及139例对照组的血清AKA，记录同期临床及实验室指标。结果：AKA对EORA诊断敏感性为31．4％，特异性为98．6％，早期EORA患者AKA阳性率28．6％，AKA阳性组IgM、血沉（ESR）较阴性组高；医生及患者对病情活动性评分、Sharp评分有增高趋势。16例AKA阳性EORA中，类风湿因子（RF）、抗核周因子（APF）、抗Sa抗体阳性数分别为11、15例和4例，AKA和APF相关。结论：AKA有助于EORA诊断及早期诊断，是病情活动性及严重性指标。

Antikeratin antibody in elderly-onset rheumatoid arthritis

Objective To determine the significance of antikeratin antibody (AKA)in patients with elderly onset rheumatoid arthritis(EORA). Methods Fifty one patients with EORA and 139 controls were assayed for AKA with indirect immunofluorescene technique using the middle third esophagus of wistar rat as antigen substrate.ESR,IgM,patients'nd physicians' global assessment of disease activity,modified Sharp's radiological progression scores,RF,antiperinuclear factor and anti Sa antibody were compared between AKA positive and negative patients with EORA. Results At the titer of 1:20,AKA was detected in 31 4% of patients with EORA,the diagnostic specificity was 98 6%.Those with positive results of AKA in early EORA made up 28 6%.ESR and IgM in AKA positive cases were significantly higher than those in negative ones.There were no significant differences in patient's and physicians' global assessment of disease activity,modified Sharps' radiological progression scores,RF,antiperinuclear factor and anti Sa antibody between the AKA positive and negative patients.There were 11 patients with RF,15 with APF,4 with anti Sa antibody in 16 AKA positive patients with EORA.AKA was associated with APF. Conclusions AKA is a valuable diagnostic tool for EORA ,especially for early EORA.It might be one of disease activity and prognostic marker for EORA.