类风湿因子及相关自身抗体对类风湿关节炎的诊断价值

目的探讨类风湿因子（RF）、抗环瓜氨酸肽抗体（抗CCP）及抗角蛋白抗体（AKA）联合检测对类风湿关节炎（RA）的临床诊断价值。方法对80例RA和65例非RA的其他自身免疫病患者检测RF、RF-IgM、抗CCP及AKA 4种指标。结果自身免疫性疾病女性发病较高,以RA组为甚;RA组的RF、RF-IgM、抗CCP及AKA高于其他自身免疫性疾病组;单指标检测RA诊断的敏感性为RF〉RF-IgM〉AKA〉抗CCP,特异性为RF-IgM〉抗CCP〉RF〉AKA。阳性预测值为抗CCP〉RF〉RF-IgM、AKA,阴性预测值为RF〉RF-IgM〉AKA〉抗CCP;以并联或串联方式联合检测均以RF、RF-IgM及抗CCP三联及RF、RF-IgM、抗CCP及AKA四联检测为佳,并联检测的敏感性分别为93%及97%,串联检测的特异性分别为98%及99%。结论 RF、RF-IgM、抗CCP及AKA 4种指标联合检测可提高对RA诊断的敏感性和特异性,对RA的早期诊断有较高价值。     

血清抗环瓜氨酸肽抗体与类风湿关节炎合并肺间质纤维化的相关性分析

分析类风湿关节炎(rheumatoid arthritis,RA)患者血清中抗环瓜氨酸肽(CCP)抗体水平与类风湿关节炎患者合并肺间质纤维化的关系.选取RA患者87例,其中合并肺间质纤维化(IPF)22例,单纯RA45例,采用酶联免疫吸附实验(ELISA)检测血清抗CCP抗体滴度,免疫比浊法检测类风湿因子(RF)滴度,...     

抗突变型瓜氨酸波形蛋白检测在类风湿关节炎中的意义

目的：评价抗突变型瓜氨酸波形蛋白（抗MCV）在类风湿关节炎（RA）诊断中的价值。方法：检测225例RA患者、77例其他关节炎患者以及80例正常对照血清中抗MCV、抗CCP和RF-IgM的水平,比较抗MCV、RF-IgM、抗CCP及抗MCV和抗CCP联合检测在类风湿关节炎的诊断中的意义。结果：①抗MCV、RF-IgM、抗CCP敏感性和特异性分别为74.67%、91.71%；77.78%、91.71%；65.33%、94.27%,抗MCV与抗CCP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60.89%、99.36%；②抗MCV与抗CCP检测对RF阴性RA病例的诊断有一定价值（30%,26%）；③抗MCV、抗CCP与RF-IgM之间均显著相关（P〈0.01）；④抗MCV与年龄、病程、功能分级、压痛关节数、ESR、CRP、X线分期及晨僵持续时间存在相关（P〈0.01或P〈0.05）,而与性别、双手平均握力和肿胀关节数无关（P〉0.05）。结论：抗MCV对RA有较高的诊断价值,抗CCP和抗MCV联合检测对RA有高度特异性,抗MCV能一定程度反映RA的临床病情,可作为RA的血清学指标。     

RF、AKA和抗CCP抗体联检对类风湿关节炎诊断的临床价值

目的:探讨类风湿因子(Rheum atoid factor,RF)、抗角质蛋白抗体(antikeratin antibody,AKA)及抗环瓜氨酸肽(anti-cyc lic c itru llinated peptide,CCP)抗体对类风湿关节炎(rheum atoid arthritis,RA)的临床意义和早期应用价值。方法:对40例类风湿关节炎患者、30例系统性红斑狼疮和30名正常健康体检者进行RF、AKA、抗CCP抗体检测,应用速率散射比浊法测定RF,间接免疫荧光法检测AKA,ELISA法测定抗CCP抗体。结果:40例RA患者血清中,RF灵敏度和特异性分别为70.0%、90.0%,AKA灵敏度和特异性分别为35.0%、96.7%,抗CCP抗体灵敏度和特异性分别为85.0%、93.3%,联检RF、AKA及抗CCP抗体灵敏度和特异性分别为97.07%、99.8%。结论:RF、AKA和抗CCP抗体可作为诊断RA比较特异的血清学指标,三项指标联检可在一定程度上弥补RF对RA的诊断不足,提高RA的阳性诊断率,且有助于疾病的预后判断。     

抗CCP抗体、APF在类风湿关节炎诊断中的意义

目的 探讨抗环瓜氨酸肽抗体(抗CCP抗体)、抗核周因子(APF)在类风湿关节炎(RA)诊断中的意义.方法 以2013年6月至2015年8月在我院接受治疗的100例RA患者为观察对象,同时选取100例干燥综合征和100例健康成年人作为对照.观察3组研究对象抗CCP抗体、APF阳性率的差异,比较炎症细胞因子水平的变化,探讨抗CCP抗体、APF联合检测对RA诊断的特异性和灵敏度.结果 3组患者抗CCP抗体、APF阳性率从高到低分别为RA组、干燥综合征组和对照组;3组患者的IL-18、IL-6和hs-CRP水平由高到低分别为RA组、干燥综合征组、对照组;RA患者的抗CCP抗体、APF阳性率与IL-18和hs-CRP水平正相关,而与IL-6水平无明显相关关系;抗CCP抗体、APF联合检测对RA诊断的灵敏度为60.53%,特异性为68.87%,明显高于上述指标单项检测时的灵敏度和特异性.结论 抗环瓜氨酸肽抗体和抗核周因子阳性表达率在类风湿性关节炎患者中较高,并与患者血清炎症细胞因子水平密切相关,且两者联合检测的灵敏度和特异性较高,可作为临床检测的重要指标.     

联合检测HLA-DR4、抗CCP抗体和抗Sa抗体在类风湿关节炎诊断中应用价值

目的 探讨联合检测HLA-DR4、抗CCP抗体和抗Sa抗体在类风湿关节炎诊断中应用价值.方法 在2014年10月至2017年1月期间,选取我院就诊的109例RA患者作为研究对象,选取同期我院收治的94例非RA患者和90例健康体检者作为对照组.比较三组患者血清HLA-DR4、抗CCP抗体和抗Sa抗体的阳性率、三项指标联合检测对RA诊断学指标.结果 RA组患者血清HLA-DR4、抗CCP抗体和抗Sa抗体阳性率显著高于非RA组和对照组(P<0.05).在HLA-DR4、抗CCP抗体和抗Sa抗体三个指标中,抗CCP抗体的灵敏度和特异性最高(P<0.05).在联合检测中,HLA-DR4、抗CCP抗体和抗Sa抗体联合检测的灵敏度和特异性最高(P<0.05).结论 HLA-DR4、抗CCP抗体和抗Sa抗体联合检测可以提高对类风湿关节炎的诊断准确率,可作为临床辅助诊断手段.     

抗CCP抗体和AKA在类风湿关节炎诊断的应用价值

目的 比较抗环瓜氨酸肽抗体(抗CCP抗体)和抗角蛋白抗体(AKA)在类风湿关节炎诊断中作用,探讨RA的早期诊断方法.方法 对已确诊的85例RA患者、74例非RA的自身免疫病患者同时测定抗CCP抗体(ELISA法)、AKA(间接免疫荧光检测).结果 抗CCP抗体对诊断RA的灵敏度和特异性分别为75.3％和93.2％;AKA对RA诊断的灵敏度和特异性分别为89.4％和85.14％.抗CCP抗体的灵敏度与AKA灵敏度差异无统计学意义(P＞0.05),特异性差异有统计学意义(P＜0.05);抗CCP抗体或AKA与二者联合检测的灵敏度差异有统计学意义(P＜0.05),特异性差异有统计学意义(P＜0.05).阳性预测值抗CCP抗体较高,阴性预测值以二者联合检测较好,Youden index二者联合检测比单独检测抗CCP抗体或AKA高.抗CCP抗体和AKA在检测RA组中抗CCP抗体和AKA同时阳性检出58例;抗CCP抗体或AKA阳性共检出85例.抗CCP抗体或AKA阳性率(96.5％)比二者同时阳性率(68.2％)大大提高.结论 抗CCP抗体、AKA对RA具有较好的灵敏度和高度的特异性,联合检测抗CCP抗体和AKA可作为早期RA患者及RF阴性RA患者的早期诊断指标.     

血清生物标志物Anti-MCV,SAA和Anti-CCP与类风湿关节炎疾病的相关性研究

目的 探讨Anti-MCV、SAA及Anti-CCP 3项生物标志物联合检测类风湿关节炎的研究价值.方法 选取2020年5月至2020年11月来本院就诊的50例类风湿关节炎(RA)患者;50例自身免疫病患者,如系统性红斑狼疮(SLE)患者、干燥综合征(SS)患者、骨关节炎(OA)患者等;50例健康对照(NC)者,分别检...     

HLA-DR4基因检测与类风湿性关节炎活动的关系

类风湿性关节炎(RA)是一种常见的以关节滑膜慢性炎症病变为主要表现的自身免疫性疾病，它的发生属遗传与外界环境共同作用所致。近年研究表明，HLA-DR4为其发病易感基因，有学者提出HLA-DR4基因影响了RA的活动度及其严重程度。本研究检测了502例类风关患者的红细胞沉降率(ESR)、c反应蛋白(CRP)、类风湿因子(RF)指     

类风湿关节炎患者外周血单个核细胞中PADI4 mRNA的表达及其意义

目的检测类风湿关节炎(RA)患者外周血单个核细胞(PBMCs)肽酰基精氨酸脱亚氨酶4(PADI4)mRNA的表达,分析其与RA患者的临床指标的相关性,探讨PADI4在RA发病机制中的作用及意义。方法实时定量PCR检测RA组(60例)、正常对照组(40例)PBMCs中PADI4 mRNA表达,并分析其与抗环瓜氨酸肽(CCP)抗体、疾病活动指数DAS28评分、C反应蛋白(CRP)、红细胞沉降率(ESR)、类风湿因子(RF)及病程等指标的关系。结果 RA组PADI4 mRNA相对表达[34.6(16.7,70.8)],明显高于正常对照组[20.6(11.1,51.8)](P<0.05)。RA组中PADl4 mRNA表达与抗CCP抗体、DAS28评分水平、ESR、RF呈正相关(r=0.527,P<0.001;r=0.416,P=0.001;r=0.371,P=0.004;r=0.287,P=0.030),与CRP、病程无相关性(r=0.015,P=0.919;r=0.064,P=0.625)。结论 RA病人外周血PBMCs PADI4 mRNA表达显著增高,并与抗CCP抗体水平、DAS28评分、ESR、RF呈正相关,可能是RA病情活动的一个有用的指标,PADI4可能在RA的发病和病理过程中起重要作用。     

骨保护素基因单核苷酸多态性与类风湿关节炎发病的相关性研究

 目的：探讨骨保护素（OPG）基因163A/G及245T/G单核苷酸多态性（SNPs）与我国汉族人群类风湿关节炎（RA）发病的相关性。方法：采用聚合酶链反应-限制性片段长度多态性（PCR-RFLP）技术检测我国南方汉族正常人群及RA患者的OPG 163A/G 和245T/G 2个SNP位点;进行Hardy-Weinberg平衡检验;计算基因型和等位基因频率,及这2个位点的连锁关系,并分析这2个SNP位点与RA的关系。结果：所研究基因分布符合Hardy-Weinberg平衡,163A/G 位点基因型AA、AG、GG分布频率在2组比较有显著差异（P<0.05）;等位基因A、G分布比较在2组有显著差异（P<0.05）,携带163GG基因型者发生RA的危险性是非携带者的1.219倍（OR=1219, 95％CI：1066~2.339, P<0.05)。但245T/G位点各基因型及等位基因频率在2组中均未见差异（P>005）。结论：OPG 基因 163A/G SNP可能与我国汉族人群RA发病相关,携带G等位基因可能是发病的危险因素。     

Association study of MICA gene polymorphisms with rheumatoid arthritis susceptibility in south Tunisian population

The aim of this study was to investigate the role of major histocompatibility complex (MHC) class I chain‐related gene A (MICA) polymorphisms, important in natural killer (NK) cell function, in patients with rheumatoid arthritis (RA). A transmembrane (TM) alanine‐encoding GCT repeats, termed A4, A5, A5.1, A6 and A9 in the MICA gene, and single‐nucleotide polymorphisms (SNPs): the Met129Val polymorphism (rs1051792) and the nonsynonymously coding SNP (rs1051794) were genotyped in 142 patients with RA and 123 unrelated healthy individuals using, respectively, PCR fluorescent method, nested PCR‐RFLP and allele specific PCR (ASP). Association was assessed based on the χ2 test, genotype relative risk (GRR) and odds ratio (OR) with 95% confidence intervals (CIs). Our results show a trend of association of the different MICA genotypes G/G, G/A and A/A (P = 0.029) which did not attain the significance after Bonferroni's correction (p_c = 0.08). Although, we revealed a significant association of the genotype A/A of MICA‐250 in patients with RA compared to healthy controls (pc = 0.033). In contrast, no significant differences between alleles and genotypes frequencies were found either with MICA‐TM or MICA met129 val (P > 0.05) in our sample. Moreover, stratification of patients with RA according to clinical and immunological data for the different polymorphisms studied shows a significant association of both MICA‐250 G allele (pc = 0.0075) and MICA‐250 GG genotype (pc = 0.008) and both allelic (val) (pc = 0.021) and genotypic (val/val) distribution (p_c = 0.0095) for MICA met129 val in the RF‐positive subgroup compared to RF‐negative patients with RA. In contrast, we found a strong association of the MICA‐TM A9 allele in RF‐negative patients with RA (p_c = 0.0003). This study indicates the involvement of the MICA‐250 polymorphism in the genetic susceptibility and severity to RA and suggests that variations in MICA‐TM and MICA met129 val may have an effect on RA severity in our south Tunisian sample.     

Association of the CTLA-4 gene with rheumatoid arthritis in Chinese Han population

Cytotoxic T lymphocyte-associated antigen 4 (CTLA-4) is important for downregulation of T-cell activation, and CTLA-4 gene polymorphisms have been implicated as risk factors for rheumatoid arthritis (RA). Previous studies of the association between the +49 polymorphism of the CTLA-4 gene in RA have provided conflicting results. In order to determine association of the CTLA-4 gene with RA in Chinese Han population, we used denaturing gradient gel electrophoresis (DGGE) to genotype polymorphisms of four SNPs (MH30, +49, CT60 and JO31) of the CTLA-4 gene in 326 RA patients and 250 healthy controls. Furthermore, meta-analysis of all available studies relating +49 polymorphism to the risk of RA was performed to confirm the disease association. Among the SNPs examined, the genotype frequencies of CTLA-4 +49 and CT60 in RA patients differed significantly from controls (P=0.028 and 0.007). In addition, the distribution of four haplotypes constructed by these two SNPs was significantly different between patients and controls (chi(2)=10.58, d.f. =3, P=0.014). The meta-analysis also revealed that in both European and Asian populations, the CLTA-4 +49 G allele was associated with the risk of RA. These results suggested that the CTLA-4 gene might be involved in the susceptibility to RA in the Chinese Han population and both +49 and CT60 of CTLA-4 gene might be the causal variants in RA disease.     

Association study of VDR gene with rheumatoid arthritis in the French population

Vitamin D is a potent regulator of calcium homeostasis and may have immunomodulatory effects. The influence of vitamin D on human autoimmune disease is controversial. The aim of this study was to investigate the role of vitamin D receptor gene (VDR) in rheumatoid arthritis (RA). Three polymorphisms for VDR gene FokI T>C (rs 10735810), BsmI A>G (rs 1544410) and TaqI C>T (rs 731236) were genotyped in 100 RA French nuclear families (set 1) and 100 additional French nuclear families for replication (set 2). The association analysis was performed using comparison of alleles frequencies (AFBAC), transmission disequilibrium test and genotype relative risk. Our results revealed a significant difference of F allele of FokI polymorphism between transmitted and nontransmitted frequencies (P=0.01) in set 1. Furthermore, the F/F genotype was more frequent in RA patients compared to controls (P=0.01) in set 1. The replication in set 2 showed similar patterns of transmission with a nonsignificant association. Association with FokI was found to be significant when the two sets were combined (P=0.006). These data suggest that the F allele and F/F VDR genotype are associated with RA. The mechanisms by which distinct receptor variants might confer disease susceptibility remain to be elucidated.     

Association of HLA-DQA1 (rs9272219) with susceptibility to rheumatoid arthritis in a Han Chinese population

HLA-DQA1 (rs9272219) has been previously reported that it is a susceptibility locus in rheumatoid arthritis (RA) of UK Caucasian population and North American; however, it has not reported in RA of Chinese population. Our study was to identify whether or not this relationship is reside between rs9272219 and RA in a Han Chinese population. 207 patients with RA and 199 control subjects were recruited. The single nucleotide polymorphism (SNP) of rs9272219 was tested in alleles and genotype frequencies and the data was analyzed by doing the statistic analysis of odds ratio (OR) and 95% confidence interval (CI) from multivariate unconditional logistic regression analyses after pairwise linkage disequilibrium (LD) was estimated. Finally, the Alleles and genotype frequencies distribution of rs9272219 locus among RA patients and control subjects were in accordance with Hardy-Weinberg equilibrium. We found significant association between rs9272219 and RA of Chinese population (OR 0.494, 95% confidence interval [95% CI] 0.354-0.688, P = 0 and OR 2.541, 95% CI 1.695-3.808, P = 0, respectively). In this study, we found that the SNP of rs9272219 in HLA-DQA1 is a potential susceptibility locus in RA of Han Chinese population; the results suggest that HLA-DQA1 may be related to the development of RA.     

广东汉族人类风湿关节炎易感性与HLA-DRB1基因相关性研究

目的探讨ＨＬＡ－ＤＲＢ１基因与类风湿关节炎（ＲＡ）相关性。方法采用ＰＣＲ－ＳＳＰ方法对４７例广东汉族人ＲＡ患者进行ＨＬＡ－ＤＲＢ１基因分型，并与相应人群健康者１０２例结果比较。结果ＨＬＡ－ＤＲ４基因在ＲＡ组显著增高（３５．１％，ＲＲ＝３．５５，Ｐ＜０．００５，ＥＦ＝０．２５２），ＤＲ１６在ＲＡ组也高于正常（ＲＲ＝２．５７，Ｐ＜０．０５）；而ＤＲ９基因在ＲＡ组显著减少（Ｐ＜０．００５）。３１例ＤＲ４＋患者患病年龄较早，病情较重（类风湿因子阳性率和Ⅱ期ＲＡ骨关节Ｘ线改变者显著高于ＤＲ４－患者，Ｐ值分别＜０．０５和０．０２５）。结论广东汉族人ＲＡ易感性与宿主ＤＲ４基因密切相关，ＨＬＡ－ＤＲ４可能是一个对判断病情和预后有价值的实验指标。     

Association of polymorphisms in pre-miRNA with inflammatory biomarkers in rheumatoid arthritis in the Chinese Han population

The aim of this study was to detect the association between 2 single nucleotide polymorphisms (SNPs), rs2910164 G>C and rs3746444 T>C, in pre-miRNA (hsa-mir-146a and hsa-mir-499) and the chronic inflammation in the Chinese Han population with rheumatoid arthritis (RA). Two hundred sixty-two Han Chinese patients with RA were recruited in this study. The SNPs were genotyped by polymerase chain reaction restriction fragment length polymorphism. C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), and the plasma concentrations of interleukin (IL)-6, tumor necrosis factor α (TNF-α), and transforming growth factor β1 (TGF-β1) were measured. There was a significant difference in the levels of CRP and ESR among different genotypes in rs3746444 (p = 0.031 and p = 0.047, respectively). The heterozygote CT had significantly higher levels of CRP and ESR compared with homozygotes CC and TT. No significant association was observed between the SNP rs2910164 and the levels of CRP, ESR, IL-6, TNF-α, and TGF-β1 (all p > 0.05). The results of this study provided the first evidence that the SNP rs3746444 in pre-miR-499 could affect the inflammatory reaction in patients with RA. The findings were significant and might contribute to the clinical assessment of inflammatory activity, which in turn may influence therapeutic decision making.     

HLA-DRB1基因多态性与新疆汉族人群结核病易感性的研究

目的 探讨HLA-DRB1基因的多态性与新疆汉族人群结核病发生发展的关联.方法 采用PCR-SSP技术对228例新疆塔城地区和石河子地区的汉族肺结核患者及231例汉族健康志愿者的HLA-DRB1的13个等位基因分型,比较各等位基因的频率(GF),统计学分析采用χ2检验,研究不同等位基因与新疆汉族人群结核病易感性的关联.结果 结核病例组HLA-DRB1*12基因频率为9.92%,明显高于对照组的2.85%,两者差异有统计学意义(χ2=18.76,Pc＜0.01);而结核病例组中的HLADRB1*11等位基因的基因频率低于健康对照组(χ2=9.513,Pc＜0.05),差异有统计学意义.结论 HLA-DRB1*12基因可能是新疆汉族人群的结核病易感基因,HLA-DRB1*11可能是新疆汉族人群与结核病相关的保护性基因.