抗环瓜氨酸抗体检测在类风湿关节炎中的临床意义

类风湿关节炎(rheumatoid arthritis,RA)是一种主要累及全身多关节的自身免疫性疾病。目前RA仍具有很高的关节致残率和病死率。早期诊断并进行积极治疗可有效减少关节畸形的可能。近年发现的抗瓜氨酸抗体(anti-citrullinated peptide anti-bodies,ACPA)可在关节破坏发生前即表现出阳性,该抗体与经典的类风湿因子(rheumatoid factor,RF)相比,在RA的诊断中具有相似的敏感性,但具有更高的特异性。研究发现抗环瓜氨酸抗体(anti-cyclic citrullinated peptide antibodies)在RA的早期诊断、预后判断等方面都有重要意义,并有流行病学证据显示其可能在RA的发病中扮演重要角色。

Detection of anti-cyclic citrullinated peptide antibodies in patients with rheumatoid arthritis: the clinical significance

Rheumatoid arthritis (RA) is an autoimmune disease involving multiple joints, and currently it still leads to high disability rate of the joints and high mortality. Early diagnosis and treatment can effectively reduce joint deformities. The recently discovered anti-citrullinated peptide antibodies(ACPA) can be detected before damage to the joints occurs. Compared with classical rheumatoid factor (RF) ACPA has higher specificity and similar sensitivity in diagnosing RA. Some studies have showned that anti-cyclic citrullinated peptide antibodies play an important role in the early diagnosis of RA and prediction of prognosis; epidemiological evidences also show that ACPA plays an important role on the pathogenesis of RA.