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目的探讨抗环瓜氨酸肽(CCP)抗体检测在幼年特发性关节炎(JIA)诊断中的意义。方法对华中科技大学同济医学院同济医院2002-06—2004-08收治的JIA患儿66例、其他风湿病患儿11例及正常儿童29名,运用酶联免疫吸附试验(ELISA)方法检测血清中抗CCP抗体,比较各组抗CCP抗体阳性率,并探讨抗CCP抗体在诊断JIA中的意义。结果66例JIA患儿中抗CCP抗体阳性率为16·7%(11/66),其中类风湿因子(RF)阳性多关节型阳性率为57·1%(4/7),RF阴性多关节型为19·0%(4/21)、少关节型为23·1%(3/13),22例全身型和3例附着点炎相关关节炎(ERA)患儿,抗CCP抗体均为阴性。其他风湿病患儿组和对照组抗CCP抗体亦为阴性。JIA组与正常对照组抗CCP阳性率比较有统计学意义(P<0·05),其中多关节型及少关节型与正常对照组比较亦有统计学意义,而其他亚型与正常对照组比较无统计学意义。结论抗CCP抗体尚不能作为JIA早期诊断的新的可靠的血清学指标。抗CCP抗体主要见于JIA多关节型和少关节型,推测抗CCP抗体对JIA分型及预后评价可能有指导意义。

The clinical significance of anti-cyclic citrullinated peptide antibodies in juvenile idiopathic arthritis

Objective To investigate the clinical significance of anti-CCP antibodies in juvenile idiopathic arthritis (JIA).Methods From June 2002 to Aug.2004,enzyme-linked immunosorbent assay(ELISA)was used for the detection of anti-CCP antibody of 106 children (including 66 cases of JIA,11 other rheumatoid disease patients and 29 healthy children) to compare the positive rate of the groups.Results Anti-CCP antibody was found in 11/66 (16.7%) JIA patients,including 4/7 patients with RF-positive polyarthritis,4/21 with RF-negative polyarthritis and 3/13 with oligoarthritis.None of the systemic onset and enthesitis-related arthritis patients was positive for anti-CCP antibody,Neither was the group of other rheuamatoid disease patients and 29 healthy children.There showed significant difference between JIA patients and control children(P<0.05),so did polyarthritis and oligoarthritis subtype compared with control children.Conclusion Anti-CCP antibody cannot yet be considered as an important serological marker for the early diagnosis of JIA.Anti-CCP antibody shows relatively higher positive rate in JIA patients of polyarthritis and oligoarthritis subtype,which indicates anti-CCP antibodies may have an important role in JIA typing and prognosis of JIA.