葡萄糖-6-磷酸异构酶抗原、抗体测定在类风湿关节炎诊断中的作用

目的探讨血清和关节液中葡萄糖-6-磷酸异构酶(G6PI)抗原和抗体含量变化与类风湿关节炎(RA)病情活动状态的关系。方法采用酶联免疫吸附试验(ELISA)测定RA患者176例、其他免疫疾病患者35例、健康体检者100例的血清标本及RA患者33例、其他免疫疾病患者11例的关节液标本中G6PI抗原和抗体水平。结果 G6PI抗原在诊断RA中的敏感度和特异度分别为75.0%和93.3%;176例RA患者血清G6PI含量为(4.37±8.65)μg/mL,显著高于疾病对照组(0.07±0.07)μg/mL(P0.01)和健康对照组(0.34±1.30)μg/mL(P0.01);在RA组中,活动期患者血清G6PI含量为(7.61±10.69)μg/mL,显著高于缓解组(0.47±0.47)μg/mL(P0.01);关节液G6PI表达量也显著高于疾病对照组,分别为(1.39±0.58)μg/mL和(0.16±0.17)μg/mL(P0.05)。以波长450 nm吸光度值(A_(450nm))表示抗体含量,G6PI抗体的含量在RA组、疾病对照组以及健康对照组之间差异无统计学意义(P0.05),在RA活动组与非活动组之间差异无统计学意义(P0.05);关节液中G6PI抗体含量RA患者与疾病对照组差异无统计学意义(P0.05)。结论 G6PI抗原在RA患者中高表达,并且与疾病活动性有密切关系。因此G6PI抗原可以作为敏感度、特异性俱佳的RA辅助诊断指标,尤其对病情判断有重要作用。而G6PI抗体在RA的诊断中价值不大,与病情活动亦无关。

The diagnostic significance of G6PI and anti-G6PI Ab of patients with rheumatoid rthritis

Objective To investigate the level of glucose-6-phosphate isomerase(G6PI) and anti-G6PI antibodies(anti-G6PI) in serum and synovia fluid of patients with rheumatoid arthritis(RA) and to study the association with the activity of RA. Methods The level of G6PI and anti-G6PI in serum samples from 176 RA patients,35 non-RA patients and 100 healthy donors and in syn-ovia fluid samples from 33 RA patients and 11 non-RA patients were tested by ELISA. Results The sensitivity and specificity of G6PI in the RA patients were 75.0% and 93.3 % respectively. The level of serum G6PI in 176 RA patients was (4.37±8.65)μg/ mL, which was significantly higher than that of the non-RA patients(0.07 ± 0.07)μg/mL, (P<0.01) and the health controls(0. 34 =±1.30)μg/mL, (P< 0.01). Eespecially, there was a significant deifference between the active phase (7.61 ± 10.69) μg/mL and the inactive phase(0. 47±0.47)μg/mL in G6PI level(P<0.01). In synovia fluid,the level of G6PI was significantly highcr in RA groups(1.39±0. 58μg/mL) than that in non-RA patients(0. 16±0. 17)μg/mL, (P<0.05). With the values of the anti-G6PI's A_(450 nm),there were no obvious differences among RA patients, non-RA patients and health controls. Also there was no difference between the active phase and the inactive phase. In synovia,the difference between RA patients and health controls were not obervi-ous. Conclusion The increased exprcssion of G6PI may play a pathological role in the development of RA,and it may be correlated with the activity of RA. It was a marker of high sensitivity and specificity for the decetion of RA. However,anti-G6PI has little val-ue on the diagnosis of RA.