摘要
目的探讨抗突变瓜氨酸化波状蛋白(MCV)抗体、抗人瓜氨酸化纤维蛋白原抗体(AhFibA)、抗免疫球蛋白重链结合蛋白(BIP)抗体在未分化关节炎(UA)进展为类风湿关节炎(RA)中的预测价值,分析其与临床相关因素的相关性。方法对62例UA患者随访8个月,记录患者的晨僵持续时间、关节肿胀、压痛数、红细胞沉降率(ESR)、C反应蛋白(CRP)、类风湿因子(RF)和抗环瓜氨酸肽(CCP)抗体。酶联免疫吸附试验(ELISA)检测抗MCV抗体、AhFibA、抗BIP抗体。用受试者工作特征曲线(ROC)评价抗MCV抗体;AhFibA;抗BIP抗体对RA的诊断价值。结果 8个月后,28例(45.0%)UA患者进展为RA,34例(54.8%)为非RA患者,进展为RA的UA患者初诊时较非RA患者晨僵持续时间长、关节对称受累多见、抗CCP抗体滴度高。抗MCV抗体在UA向RA进展中有预测价值,其曲线下面积(AUC)为0.816。敏感性和特异性分别为0.643和0.824。AhFibA在UA向RA进展中无预测价值,其AUC为0.522。抗BIP抗体在UA向RA进展中有预测价值,其AUC为0.856。敏感性和特异性分别为0.339和0.720。抗MCV抗体与肿胀、压痛关节数(r=0.488,P=0.000)、抗CCP抗体相关(r=0.509,P=0.006)。AhFibA与抗CCP抗体相关(r=0.402,P=0.034)。抗BIP抗体与CRP相关(r=0.371,P=0.026)。结论抗MCV抗体、抗BIP抗体滴度升高对于UA向RA进展具有预测价值,AhFibA可能无预测价值。
Objective To investigate the clinical values of mutated citrullinated vimentin（MCV）,anti human fibrinogen antibodies（AhFibA） and Ig heavy chain binding protein（BIP） in the transition from undifferentiated arthritis（UA） to rheumated arthritis（RA）,and analyze the clinical relevant factors.Methods 62 patients with UA who were followed up for 8 months were enrollde into the study.Anti-MCV,AhFibA,Anti-BIP,were detected by ELISA.The duration of morning stiffness,the numbers of swelling and tender joints,rheumatoid factor（RF）,Erythrocyte sedimentation rate（ESR） and C-reactive protein level（CRP）,anti-cyclic citrullinated peptide（anti-CCP） were recorded.The receiver operating characteristic curve（ROC） was used to evaluate the diagnostic value of anti-MCV,AhFibA and Anti-BIP.Results After 8 months,28（45%）patients were classified as having RA and 34（54.8%）were classified as non-RA patients.Anti-CCP tities were higher than non-RA patients.The area under the curve（AUC）of anti-MCV was of RA patients were higher than non-RA patients and the duration of morning stiffness 0.816.The AUC of AhFibA was 0.522,The AUC of Anti-BIP was 0.856.Indicating that Anti-MCV and Anti-BIP had predictive value for RA with？,but not with AhFibA.There was corrlation between anti-MCV and the numbers of swelling and tender joints,（r=0.488,P=0.000）,and Anti-CCP（r=0.509,P=0.006）.Conclusion Anti-MCV and Anti-BIP have predictive value in the transition from UA to RA.
出处
《安徽医学》
2011年第11期1812-1816,共5页
Anhui Medical Journal
