抗环瓜胺酸肽抗体和葡萄糖-6-磷酸异构酶抗原在类风湿性关节炎中的意义

目的探讨抗环瓜胺酸肽抗体（cyclic citrullinatedpeptide,CCP）和葡萄糖-6-磷酸异构酶抗原（glucose-6-phosphate isomerase,GPI）在类风湿性关节炎中的意义。方法采用酶联免疫吸附试验（ELISA）间接法检测90例RA患者血液中的CCP抗体,采用双抗体夹心酶联免疫吸附试验（ELISA）同样检测90例RA患者血液中的GPI。结果在GPI组Ⅳ期的RA阳性率明显高于Ⅰ期及Ⅱ期～Ⅲ期患者（P〈0.05）,有统计学意义。CCP组在Ⅰ期、Ⅱ期～Ⅲ期和Ⅳ期无统计学意义。GPI在ESR〉100组的阳性率显著高于ESR〈40和40≤ESR≤100组（χ^2=10.045,P=0.007）;抗CCP在各组的阳性率无显著性差异（χ^2=4.432,P=0.109）。结论抗CCP抗体和GPI抗原在RA的诊断中都有重要意义。抗CCP抗体在RA的早期诊断和骨侵蚀方面更有价值,而GPI抗原特异性高于抗CCP抗体和RF,同时,它还能反映关节的炎症程度及RA的活动性。

Significance of cyclic citrullinatedpeptide and glucose-6-phosphate isomerase in rheumatoid arthritis

Objective To explore the clinical value of anti-cyclic citrullinatedpeptide （CCP） antibody and glucose-6phosphate isomerase （GPI） antigen in patients with rheumatoid arthritis （RA）.Methods Anti-CCP antibody in 90 RA serous samples was detected by indirect ELISA and GPI antigen by sandwich ELISA.Results GPI positive rate in patients of X-ray phase Ⅳ was significantly higher than those in phase I and from phase Ⅱ～Ⅲ （P〈0.05）.While anti-CCP antibody was not statistically significant among groups of phase I,phase Ⅱ ～ Ⅲ or phase Ⅳ.GPI positive rate in patients with erythrocyte sedimentation rate （ESR）100mm/h was significantly higher than those with ESR 40mm/h or 40～100mm/h （χ^2=10.045,P= 0.007）,while anti-CCP antibody was not statistically significant （χ^2=4.432,P=0.109）among different ESR groups.Conclusion Anti-CCP antibody and GPI antigen are both important in diagnosing RA.Anti-CCP antibody has more significant value in bone erosion and early diagnosing of RA,while GPI antigen in reflecting inflammation degree and RA activity with higher specificity than anti-CCP antibody and rheumatic factor（RF）.