类风湿关节炎患者血清GPI检测及其诊断价值的研究

目的探讨血清葡萄糖-6-磷酸异构酶（GPI）水平与类风湿关节炎（RA）发病的相关性及其对RA诊断的价值。方法采用ELISA法检测68例RA患者、69例非RA自身免疫性疾病患者和77例健康体检者血清GPI水平，常规检测RA患者类风湿因子（RF）、红细胞沉降率（ESR）、C反应蛋白（CRP）和抗CCP抗体水平。结果RA患者血清GPI水平为（7．01±8．03）mg／L，非RA自身免疫性疾病患者为（O．30士0．57）mg／L，健康体检者为（O．22±0．65）mg／L，RA患者血清GPI浓度显著高于非RA自身免疫性疾病患者和健康体检者（P〈0．001）。活动性RA患者和非活动性RA患者血清GPI水平比较，差异有统计学意义（P〈0．01）。以0．332mg／L为临界值，GPI检测用于RA诊断的灵敏度和特异度分别为70．6％和92．2％，ROC曲线下面积为0．901；GPI水平与RF、ESR、CRP及抗CCP抗体水平呈正关，相关系数分别为0．645、0．480、0．389和0．623（均P〈0．05）。结论RA患者血清GPI水平显著升高，GPI有可能成为诊断RA及判断RA活动性的一个新指标。

Serum glucose-6-phosphate isomerase measurement and its diagnostic value on rheumatoid arthritis

Objective To detect the serum level of glucose-6-phosphate isomerase （GPI） and evaluate the diagnostic value on rheumatoid arthritis （RA）. Methods The concentration of serum GPIin 68 patients with RA,69 non-RA patients with other auto- immune diseases and 77 normal controls were assayed by ELISA. The level of RF,CRP,anti-CCP antibody and ESR were also as- sayed in RA patients. Results GPI serum level were （7.01±8.03）mg/L in RA patients, （0. 304-0.57）mg/L in non-RA patients with other autoimmune diseases and （0.22 ±0.65）mg/L in control group. The level of GPI was statistically higher in RA patients than the other two groups （P~0.05）, and it was also statistically higher in active RA patients than inactive RA patients. When 0. 332 mg/L was regarded as cut-off value,the sensitivity and specificity of GPI for RA were 70.6% and 92.2% respectively,and the area under the ROC curve was 0. 901. Spearman rank correlation analysis showed the level of serum GPI positively correlated with ESR,CRP and anti-CCP antibody,with correlation coefficients of 0. 480,0. 389 and 0. 623 respectively. Conclusion Serum lev- el of GPI increases significantly in RA patients and it could be used as a new indicator for RA diagnosis and activity judgment.