抗核周因子的检测及其在类风湿关节炎中的意义

目的 了解抗核周因子（ＡＰＦ）对类风湿关节炎（ＲＡ）的诊断价值，并探讨其与ＲＡ病情的关系。方法 以健康人颊粘膜细胞为抗原，采用间接免疫荧光法检测１４３例ＲＡ，１８４例其他风湿病患者和１６８例正常人的血清ＡＰＦ；ＲＡ病人的红细胞沉降率（ＥＳＲ），类风湿因子（ＲＦ），抗鼠食管角质层抗体（ＡＫＡ），抗ＲＡ３３抗体，医生和患者病情活动性评价，压痛及肿胀关节指数，放射学病情进展改进的Ｓｈａｒｐ评分也同时评估

Detection of antiperinuclear factor and its clinical significance

Objective To determine the significance of antiperinuclear factor (APF) in the diagnosis of rheumatoid arthritis (RA),and its relationship with disease activity and severity. Methods Based on the antigenic substrate in human bucca mucosa cells,APF was measured with indirect immunofluorescence technique in 143 patients with RA,184 with miscellaneous rheumatic diseases and 168 healthy individuals.The erythrocyte sedimentation rate (ESR),Creactive protein,RF,antibodies to the stratum of rat oesophagus (AKA),antiRA33 antibodies,patients and physicians global assessment of disease activity,tender joint count,swollen joint count and modified Sharps radiological progression scores were compared between APF positive and negative RA patients. Results At the titer of 110,APF was detected in 678% (97/143) of RA patients,and 9 cases of control group.The diagnostic specificity for RA was 974%.The occurrence of APF in the early RA was 659% (27/41).The patientss and physicians global assessment of disease activity,ESR,AKA,RF positive rate and its mean titer in APFpositive RA cases were significantly higher than those in APFnegative ones. Conclusion APF is a valuable diagnostic tool and a useful additional marker for RA,and might be a useful prognostic marker and a test of the disease activity of RA,especially it is helpful in the early diagnosis of RA.