血清葡萄糖-6-磷酸异构酶在类风湿关节炎诊断中的应用研究

目的探讨葡萄糖-6-磷酸异构酶(GPI)在类风湿关节炎(RA)诊断及与其他自身免疫性疾病鉴别诊断中的价值,并对GPI在RA中的致病机理进行初步分析。方法检测RA组、健康对照组和其他自身免疫性疾病对照组血清的GPI、类风湿因子(RF)和补体C3、C4浓度,对各组间检测结果进行统计分析。结果RA组的GPI浓度值和阳性率都显著高于其他自身免疫疾病对照组和健康对照组(P<0.001),且RA活动组GPI浓度值和阳性率显著高于RA非活动组(P<0.001);在GPI阳性的RA病例中,C3浓度升高,而C4不升高。结论GPI在RA中的检测意义要大于其他自身免疫性疾病,且它的升高程度与关节炎的活动性有关,GPI和RF联合检测对RA的鉴别诊断具有较高价值;GPI可通过替代途径激活补体系统,损伤关节表面,导致RA的发生。

Study of serum glucose-6-phosphate isomerase in the diagnosis of rheumatoid arthritis

Objective To explore the differential diagnostic value of glucose-6-phosphate isomerase(GPI) in rheumatoid arthritis(RA) and other autoimmune diseases and to study the mechanism of GPI in RA.Methods The level of serum GPI,RF,C3 and C4 in the patients with RA,normal controls and other autoimmune diseases were assessed.And then all the results were analysed.Results The concentration and positive rate of GPI in RA group were significantly higher than those in disease control and normal control groups(P<0.001).And, the concentration and positive rate of GPI in RA activity group were significantly higher than those in RA nonactivity group(P<0.001).The concentration of C3 in RA patients with high GPI concentration was higher than that in the normal control,and yet C4 was not.Conclusion GPI is not specigic diagnostic test for RA,but combining detection of GPI and RF has much differential diagnostic value than each one of GPI or RF.GPI can activate the complement system through the alternative pathway,and then injure joint surface,finally lead to RA.