早期类风湿性关节炎患者血清抗突变型瓜氨酸波形蛋白抗体的水平变化意义

目的探讨血清抗突变型瓜氨酸波形蛋白（MCV）抗体水平在诊断类风湿性关节炎（RA）中的意义。方法用酶联免疫吸附试验（ELISA）测定73例RA患者血清抗MCV抗体水平,并同步分别应用ELISA、放射免疫分析法及增强比浊法检测抗环瓜氨酸多肽（CCP）抗体、肿瘤坏死因子α（TNF-α）和类风湿因子（RF）水平,与35例非RA患者和40名健康体检者进行对照比较。结果RA组血清抗MCV抗体水平显著高于健康对照组（P〈0.01）;非RA组与健康对照组间差异无统计学意义。抗MCV抗体对RA诊断的敏感性为83.56%（61/73）,特异性为96.00%（72/75）,均高于抗CCP抗体及RF;相关分析显示RA患者抗MCV抗体水平与抗CCP抗体、TNF-α及RF呈显著正相关（r=0.531、0.243、0.347,P均〈0.01）。结论抗MCV抗体与RA联系密切,为一高度敏感的、新的RA标记物,临床上检测血清抗MCV抗体水平对于筛查和辅助早期诊断RA具有重要意义。

Diagnostic value of serum anti-mutated citrullinated vimentin antibody in patients with early rheumatoid arthritis

Objective To evaluate the diagnostic value of serum anti-mutated citrullinated vimentin （MCV） antibody in patients with early rheumatoid arthritis （ RA ）. Methods Enzyme-linked immunosorbent assay （ ELISA ） was used to detect the level of serum anti-MCV antibody and anti-eyclin citrullinated peptides （CCP） antibody in 73 patients with RA, 35 patients with other autoimmune diseases and 40 healthy controls. The serum level of tumor necrosis factor- α（TNF-α） was measured by radioimmunoassay. The serum level of rheumatoid factor （RF） was detected by latex-enhanced nephelometry immunoassay. Results The levels of serum anti-MCV antibody in patients with RA were significantly higher than those in healthy controls （P 〈 0.01 ）. There were not significant differences between the patients with other autoimmune diseases and the healthy controls. The sensitivity of auti-MCV was 83.56% （61/73） ,and the specificity was 96.00% （72/75）. They were both higher than anti-CCP and RF. Correlation analysis results suggested that the serum anti-MCV antibody levels were positively related to anti-CCP antibody,TNF-α and RF（ r = 0. 531,0. 243,0. 347, P 〈 0.01 ）. Conclusions Anti-MCV antibody has high sensitivity and specificity in the diagnosis of RA, and it can be a good new diagnostic marker. It has an important significance in screening and early diagnosis for RA.