摘要
目的比较分析幼年特发性关节炎(JIA)和成人类风湿关节炎(RA)患儿血清抗环瓜氨酸肽(CCP)抗体水平,探讨抗CCP抗体在JIA诊断中的价值和意义。方法 2009年2-12月首都儿科研究所风湿免疫科确诊的JIA患儿72例。男33例,女39例;年龄(7.58±3.93)岁,全身型29例,少关节型27例,多关节型16例。同期在中国人民解放军总医院风湿科确诊的RA患者共65例。男14例,女51例;年龄(47.38±14.28)岁。健康对照组22例,为同期健康查体儿童。男10例,女12例;年龄(14.10±0.38)岁。选用英国Axis-shield Diagnostics Limit公司、德国欧蒙公司和上海富莼科芯公司生产的CCP抗体ELISA检测试剂盒,分别检测JIA患儿、RA患者和健康儿童血清CCP抗体水平。结果英国Axis-shield Diagnostics Limit公司检测JIA患儿血清抗CCP抗体的阳性率为12.5%(9/72例),RA患者血清阳性率高达73.85%(48/65例),健康对照组无阳性(0/22例)。RA患者血清抗CCP抗体阳性率显著高于JIA患儿(P<0.01),其中JIA组中多关节型阳性率31.25%(5/16例),少关节型阳性率14.8%(4/23例),全身型阳性率为0(0/29例),差异有统计学意义(P<0.001)。另2家公司试剂盒检测结果JIA患儿血清抗CCP抗体的阳性率为15.3%(11/72例),RA患者血清阳性率为73.85%(48/65例),健康儿童无阳性。RA患者血清和健康儿童血清结果3家公司检测试剂盒完全一致。JIA患儿3种抗CCP抗体试剂盒检测结果之间差异无统计学意义(P>0.05)。结论 ELISA方法检测血清抗CCP抗体水平较为稳定可靠,抗CCP抗体在JIA患儿中血清阳性率低于成人RA,抗CCP抗体在JIA各亚型分布差异显著,抗CCP抗体与多关节型相关。
Objective To evaluate the value of anti - cyclic citrullinated peptide antibodies （CCP） in the diagnosis of juvenile idiopathic arthritis （JIA） by analyzing results of detection from both JIA and adult rheumatoid arthritis （RA） patients. Methods Seventy -two samples with JIA（33 male ,39 female） ,diagnosed by the Department of Rheumatism of the Capital Institute of Pediatrics from Feb. 2009 to Dec. 2009, aged （7.58 ± 3.93 ） years old, including 29 polyarticular JIA, 27 oligoarticuar JIA and 16 systemic JIA; 65 samples with RA （ 14 male,51 female） were diagnosed by the Department of Rheumatism of General Hospital of the Chinese People＇s Liberation Army, aged （47.38± 14.28 ） years old; 22 healthy children （ 10 male, 12 female）in the healthy control group, aged （ 14.1 ± 0.38 ） years old. Anti - CCP antibody in serum was detected in JIA children,RA patients and normal children by enzyme -linked immunosorbent assay（ELISA） kits from Axis - shield Diagnostics Limited, United Kindom（UK） ; EUROIMMUN, Germany and Shanghai Fuchunkexin biotech company, China. Results The positive rate of anti - C CP antibody was 12.5 % （9/72 cases）in JIA children,73.85 % （48/65 cases）in RA patients using the kits from UK, and there was a significant difference （P 〈 0.01 ）. Furthermore,the positive rate of anti -CCP antibody was 31.25% （5/16 cases）in the children with polyar- ticular JIA, 14.8% （4/23 cases） in the oligoarticuar JIA and zero （0/29 cases） in the systemic JIA, and the difference was significant （ P 〈 0.001 ）. As for the kits from the other 2 companies ,the positive rate of anti - CCP antibody in JIA children was 15.3% （ 11/72 cases）. As to the RA patients and the healthy control children,the results were conformed between the 3 kits from different companies. With further analysis,there were higher incidence of anti - CCP antibody in the RA patients as compared with that of the JIA children, by using 3 kits. There was a good conformance of the 3 E
出处
《实用儿科临床杂志》
CAS
CSCD
北大核心
2011年第21期1626-1628,共3页
Journal of Applied Clinical Pediatrics
基金
国家"十一五"科技支撑计划课题(2008BAI59B02)
关键词
类风湿关节炎
儿童
成人
抗环瓜氨酸肽抗体
rheumatoid arthritis
child
adult
anti -cyclic citrullinated peptide antibodies
