摘要
目的：探讨中国汉族类风湿关节炎（RA）患者中抗环瓜氨酸肽抗体（ACCP）与人类白细胞抗原（HLA）-DR4基因的相关性。方法：入选RA104例、正常对照122名。ACCP检测采用酶联免疫吸附法（ELISA）,类风湿因子检测采用散色比浊法,HLA-DR4基因采用序列特异性引物-聚合酶链方法（PCR-SSP）检测。结果：RA患者中HLA-DR4基因携带率为34.6%,主要亚型为HLA-DRB1＊0405,正常对照组为17.2%,差异有统计学意义（P=0.01）。RA患者的共同表位（SE）携带率为30.9%,与国内相关研究结果（33.2%,36.8%）相似,但明显低于国外相关研究（78.5%,65.4%,85%,67%）,差异有统计学意义（P〈0.01）。RA患者中ACCP阳性率为76.5%,与国内外报道相符,正常对照组为0,两者差异有统计学意义。SE（＋）患者的ACCP阳性率为84%,SE（-）患者的ACCP阳性率73.2%,两者差异无统计学意义。RA患者中ACCP的滴度与X线分期相关（r=0.233,P〈0.05）。结论：我国汉族RA患者中ACCP与HLA-DR4或SE无明显的相关性。ACCP可能与关节破坏的严重程度相关。
Objective Rheumatoid arthritis （RA） is associated with a group of HLA-DRB1 alleles which share a common amino acid sequence at residues 70-74. Anti-cyclic citrullinated peptide （ACCP） anti- bodies have been reported to be associated with HLA-DR4 or shared epitope （SE） in western rheumatoid arthritis patients. This work is aimed to test if there is association between the SE （HLA-DRBl＊0401/04/05/10） and ACCP antibodies in Chinese Han population. Methods One hundred and four RA patients and one hundred and twenty two healthy controls were recruited. HLA-DR4 was detected by PCR-SSP phototyping method. ACCP antibodies and IgM-rheumatoid factor （RF） were measured by ELISA and laser nephelometry, respec- tively. Results 76.5% of Chinese patients with RA exhibited ACCP antibodies, while none in the controls. The prevalence of SE was significantly higher in patients with RA than in controls （P=0.0096, OR=2.42, 95%CI= 1.16-5.07）. Among the HLA-DR4 alleles, the presence of HLA-DRBl＊0401 was significantly higher in RA pa- tients than in controls （P=0.0118, 0R=9.68, 95%CI=1.13-448.8）. In our study the carriership of SE was not associated with production of ACCP antibodies （P=-0.2899, 0R=0.521, 95% CI=0.003-1.935）. Conclusions The prevalence of SE is significantly low in Chinese RA patients,in contrast to the reports from western countries. Our data emphasies the complexity of genetic effects on RA phenotype.
出处
《中华风湿病学杂志》
CAS
CSCD
2007年第9期528-531,共4页
Chinese Journal of Rheumatology
基金
上海市卫生局科研基金资助项目（99428）
