类风湿性关节炎患者血清免疫球蛋白和自身抗体水平的检测与分析

目的测定类风湿性关节炎(RA)患者血清免疫球蛋白IgG、IgA、IgM和自身抗体(ANA、抗ds-DNA、抗ENA)水平,并探讨两者与RA及两者之间的关系。方法应用速率散射比浊法、间接免疫荧光法和免疫印迹法等对40例初诊RA患者和30例正常人血清IgG、IgM、IgA和类风湿因子(RF)及自身抗体水平进行检测。用t检验和字2检验分析这些自身抗体与Ig水平的关系。结果RA患者血清IgA、IgG、IgM水平升高,与正常人相比存在显著性差异(P<0.05)。40例患者中有26例检出1种或多种自身抗体或RF,其中以RF检出率最高,为8例。患者中自身抗体或RF阳性组IgA水平高于阴性组(P<0.01);IgA水平高于正常参考范围上限组自身抗体阳性率(83.3%,15/18)高于IgA水平在正常参考范围以内组(50%,11/22;P<0.05)。结论RA患者血清免疫球蛋白升高与自身抗体阳性关系密切,血清IgA水平升高者自身抗体阳性率明显高于IgA水平在参考范围以内者。

Analysis of the relation between serum immunoglobulin and auto-antibody levels in patients with rheumatoid arthritis

Objective To explore the relationship be tw een serum immunoglobulin (Ig) levels and the positivity rate for auto-antibodi es in patients with rheumatoid arthritis (RA). Methods The levels of immunoglobu lins (IgG, IgM, IgA) and rheumatoid factor (RF) were measured using Olympus AU6 00 system, and indirect immunofluourescence and immunoblotting methods were em ployed respectively for detecting the autoantibodies in the serum from 40 RA patients and 30 normal adults. Statistical analysis of the relation between the Ig levels and autoantibodies was performed. Results Compared with no rmal control group, significantly higher serum IgA, IgG and IgM levels were det ected in RA patients (P<0.01), and at least one autoantibody was present in the serum sample from 26 out of the 40 RA patients, who had the highest RF positivi ty rate of 20% (8 cases). The serum IgA level in autoantibody-positive patients was significantly higher than that in autoantibody-negative ones (P<0.01), and in the 18 patients with serum IgA level beyond the normal range, 15 (83.3 %) wer e positive for autoantibody, while in the 22 patients with normal serum IgA lev el, the autoantibody positivity rate was only 50 % (11/22), showing significant difference (P<0.05). Conclusion Serum immunoglobulins A (IgA) level is closely associated with the positivity rate for autoantibodies in RA patients, and RA p atients with serum IgA level beyond the normal range was more likely to be posi tive for the autoantibodies.