血清抗环瓜氨酸多肽抗体与类风湿关节炎心血管并发症相关性的研究

目的 探讨类风湿关节炎(RA)患者血清中抗环瓜氨酸肽(CCP)抗体与心血管并发症的相关性.方法 选取RA患者78例,其中并发心血管并发症40例,单纯RA 38例,采用酶联免疫吸附法(ELISA)检测血清抗CCP抗体滴度,免疫比浊法检测类风湿因子(RF)滴度,并分析两者与RA合并心血管并发症的关系.结果 单纯RA组抗CCP抗体阳性率为74.6％,RA并发心血管病变组抗CCP抗体阳性率为87.3％；RA并发心血管病变组与单纯RA组不同抗CCP抗体滴度发病率差异有统计学意义(x2=5.07、9.04、6.48,均P＜0.05)；单纯RA组患者RF阳性率为76.5％,RA并发心血管病变组患者RF阳性率95.8％,两组差异有统计学意义(x2 =33.41,P ＜0.05)；两组不同RF滴度发病率差异有统计学意义(x2=26.05、34.14,均P＜0.05).RA并发心血管病变患者抗CCP抗体与RF进行Spearman相关分析,结果表明两者无明显相关性(r=0.301,P=0.174).结论 RA并发心血管并发症以老年患者多见,高滴度抗CCP抗体和RF可能与RA患者合并心血管并发症的发生与发展密切相关.

Relationship between anti-cyclic Citrullinated petide antibody and cardiovascular complication associated with rheumatoid arthritis

Objective The aim of this study was to assess the relationship between the level of anti-CCP antibody and cardiovascular（CV） risk in rheumatoid arthritis（RA） patients. Methods A total of 78 RA patients were enrolled in the study. They were divided into two groups：40 cases with CV complitations which were secondary from RA and 38 cases with no complications. The anti-CCP antibody was diagnosed by enzyme - linked immunoabsorbent assay（ELISA） and rheumatoid factor（RF） were assessed by immunoturbidimetry method. The relationship between the levels of the two sera auto-antibodies and CV disease associated with RA was analyzed. Results The results showed that the level of anti-CCP antibody in RA-CV disease group was significantly higher than that in simple RA group（74.6% VS 87. 3% ）. Compared with the simple RA group,the level of anti-CCP antibody in the RA-CV disease group was higher, and with significant difference between the two groups （χ2 = 5.07,9.04,6.48, all P 〈 0.05 ）. RF positive rate was 95.8% of the patients with RA-CV disease while it was 76.5% in simple RA group, and the difference between the two groups was statistically significant（ χ2 = 33.41,26.05,34.14, all P 〈 0.05 ）. The morbidity between the different level of RF had remarkable difference. In RA patients with CV complations, we compared anti- CCP antibody and RF by Spearman analysis, whish showed no relationship between them（ r = 0. 301, P = 0. 174 ）. Conclusion The results indicated that CV disease secondary from RA was more common in old patients. In RA patients the high level of anti-CCP antibody and RF maybe play an important role in the appearance of CV disease.