重组人Ⅱ型肿瘤坏死因子受体-抗体融合蛋白对类风湿关节炎患者自身抗体的影响

目的 了解重组人II型肿瘤坏死因子受体-抗体融合蛋白益赛普对类风湿性关节炎（RA）患者血清自身抗体的影响。 方法 选取24例处于活动期的RA患者，年龄28~56岁，其中女性19例，男性5例，病程0.5～3年。益赛普25mg皮下注射，每周两次，共治疗12周。在益赛普治疗前、后抽取患者血清，分别检测血清中类风湿因子（RF）、抗核抗体（ANA）、抗ENA抗体、抗双链DNA（ds-DNA）抗体、抗组蛋白抗体、抗心磷脂抗体（aCL）、抗中性粒细胞胞浆抗体（ANCA）等自身抗体。 结果 益赛普治疗12周后，RF水平较治疗前明显下降（P＜0.01）；治疗后ANA、抗dsDNA抗体及抗组蛋白抗体阳性率较治疗前明显升高（P＜0.05）；而治疗前、后抗ENA抗体、aCL、ANCA的阳性率无显著性变化，24例RA患者中无一例出现系统性红斑狼疮样综合征。 结论 RA患者使用益赛普治疗后可以出现自身抗体的变化，但没有发现患者出现系统性红斑狼疮样综合征。

The Effect of Recombinant Human Tumor Necrosis Factor Receptor-Fc Fusion Protein on the Autoantibodies Profile in Patients with Rheumatoid Arthritis

Objective To investigate the effect of recombinant human tumor necrosis factor receptor-Fc fusion protein (Etanercept) on serum level of autoantibodies profile in patients with rheumatoid arthritis (RA). Methods Twenty-four patients who had active RA were treated with twice-weekly subcutaneous Etanercept (25 mg) for twelve weeks. Sera were analyzed for rheumatoid factor (RF), antinuclear antibodies (ANA), anti-extractable nuclear antigen (anti-ENA) antibodies, anti-double-stranded DNA (anti-dsDNA) antibodies, anti-histone antibodies, anticardiolipin antibodies (aCL), and anti-neutrophil cytoplasma antibodies (ANCA). No lupus-like syndrome was seen in all patients. Results The serum level of RF decreased significantly after Etanercept treatment (P＜0.01). The number of patients treated with Etanercept who developed antibodies against ANA and ds-DNA increased significantly (P＜0.05). The number of ENA, aCL, ANCA positive patients was stable. Conclusions Etanercept treatment can induce formation of autoantibodies in patients with RA. No patient develops drug-induced lupus erythematosus.