抗环瓜氨酸肽抗体在幼年特发性关节炎诊断中的意义

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。

Pregnancy and outcomes of patients with uterine leiomyoma after uterine arterial embolization

AbstractObjectiveTo investigate the clinical significance of anti CCP antibodies in juvenile idiopathic arthritis (JIA).MethodsFrom 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.ResultsAnti 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.ConclusionAnti 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.