摘要
目的 探讨抗鼠科肉瘤病毒癌基因同源物B1（BRAF）抗体在RA患者血清中表达水平及其临床意义.方法 应用ELISA检测RA 129例、其他风湿性疾病组71例和健康对照组68名血清中抗BRAF抗体水平,并将129例RA患者按抗BRAF抗体水平分为高、中、低3组,每组43例.记录各组的临床症状、免疫学检查结果及相关影像学资料,探讨RA组血清中抗BRAF抗体水平与临床症状、免疫学检查结果及相关影像学变化之间的关系.组间比较采用Mann-Whitney U检验、x2检验或Fisher确切概率法.变量间相关性分析采用Spearman相关分析.结果 ①RA组血清中抗BRAF抗体水平[A值：1.093（0.150～3.210）]明显高于其他风湿性疾病组[A值：0.278（0.093～0.455）]及健康对照组[A值：0.202（0.121～0.443）（Z=-11.223,P=0.021;Z=-7.839,P=0.008 7].其他风湿性疾病组和健康对照组抗BRAF抗体水平差异有统计学意义（Z=-0.905,P=0.445）.②RA组中抗BRAF抗体高、中、低水平3组间RF阳性率差异有统计学意义（x2=10.14,P=0.006）,即抗BRAF抗体低水平组阳性率（88％）明显高于高水平组（58％）（x2=10.03,P=0.002）.3组间抗CCP抗体、AKA阳性率差异无统计学意义（x2=0.721,P=0.697;x2=1.735,P=0.188）.③RA组中抗BRAF抗体水平与患者病程（r=-0.233,P=0.047）、RF（r=-2.84,P=0.039）、IgM（r=-0.234,P=0.038）、血红蛋白（r=-0.287,P=0.032）呈负相关;与关节肿指数（r=-0.133,P=0.230）、关节痛指数（r=-0.173,P=0.100）及其他临床、实验室指标无明显相关性.该组中ESR与血红蛋白呈负相关（r=-0.287,P＜0.05）.④RA组中关节骨质正常组与骨质破坏组抗BRAF抗体水平差异无统计学意义（Z=-0.642,P=0.521）.⑤RA组中胸部CT正常组与肺间质纤维化组抗BRAF抗体水平差异无统计学意义（Z=-0.121,P=0.904）.结论 抗BRAF抗体可作为新的自身抗体应用于RA患者的诊断,并对早期RA患者及RF阴性的RA患者有一定的诊断价值,与关节骨
Objective To investigate the serum levels of anti-BRAF antibody in patients with rheumatoid arthritis （RA） and its clinical significance.Methods Blood samples from 129 patients with RA,71 patients with other rheumatic diseases and 68 healthy controls were measured by enzyme-linked immunosorbent assays （ELISA）.The serum levels of anti-BRAF antibody in patients with RA were divided into high,medium and low groups,each group had 43 cases.The clinical symptoms,immunological findings and related imaging data of all cases were recorded.We investigated the relationship between the serum levels of anti-BRAF antibody and the clinical symptoms,immunological findings and related imaging changes of the RA group.Chi-square test,Mann-Whitney U test,Spearman＆#39;s correlation test were used for statistical analysis.Results ① The serum levels of anti-BRAF antibody were significantly higher in RA group [A：1.093 （0.150-3.210）] than in other rheumatic diseases group [A：0.278 （0.093-0.455）] and healthy controls [A：0.202 （0.121-0.443）] （Z=-11.223,P=0.021 ; Z=-7.839,P=0.008 7）.The serum levels of anti-BRAF antibody was not significantly different between patients with other rheumatic diseases group and healthy controls （Z=-0.905,P=0.445）.② The difference in positive rate of rheumatoid factor （RF） in different groups of anti-BRAF antibody levels was statistically significant （λx2=10.14,P=0.006）,namely the positive rate was significantlyhigher in the low-level group （88%） than in the high-level group （58%） （x2=10.03,P=0.002）.Thepositive rate of anti-cyclic citrullinated peptide antibody and anti-keratin antibody of the three groups was not significantly different （x2=0.721,P=0.697; x2=1.735,P=0.188）.③ There was significant negative correlation between the levels of anti-BRAF antibody and the course of disease （r=-0.233,P=0.047）,RF（r=-2.84,P=0.039）,IgM （r=-0.234,P=0.038）,and hemoglobin （r=-0.287,P=0.032）.There was no significant correlation between the lev
出处
《中华风湿病学杂志》
CAS
CSCD
北大核心
2014年第4期240-243,共4页
Chinese Journal of Rheumatology
基金
基金项目：宁夏回族自治区卫生厅科研项目（2012134）
