摘要
目的 检测隐匿性IgM型类风湿因子 (HIgM RF)并探讨其在幼年类风湿关节炎 (JRA)中的临床意义。方法 利用聚乙二醇 (PEG)分离含类风湿因子 (RF)的免疫复合物 ,在酸性条件下解离出RF ,以酶联免疫吸附试验方法 ,测定HIgM RF。 6 8例JRA患儿中的 16例在活动期和缓解期HIgM RF ,与正常对照组 (35例 )比较。结果 (1)HIgM RF在JRA的阳性率为 71 4% ,其中多关节炎型阳性率为 80 0 % ,少关节炎型阳性率为 71 4% ,全身型阳性率 5 8 8%。 (2 )多关节炎型、少关节炎型、全身型JRA活动期HIgM RF均值高于缓解期 ,差异均具有非常显著意义 (t=11 15 ,t=14 6 7,t=5 78;P<0 0 1)。全组活动期JRA均值同正常对照组比较 ,差异有显著性 (F =16 34,P <0 0 1)。但缓解期均值同正常组比较差异未见显著性意义 (P >0 0 5 )。 (3)HIgM RF与血沉 (ESR)、C 反应蛋白 (CRP)正相关 (r=0 6 9,P <0 0 1;r=0 32 ,P <0 0 1)。同年龄、性别、病程无关。结论 HIgM RF在JRA中有较高的检出率 ,并与病情活动性有关 ,可作为JRA诊断。
Objective It was reported that hidden IgM rheumatoid factor was associated with juvenile rheumatoid arthritis (JRA) However, we have rarely seen such reports in Chinese journals The present study was to determine the presence of hidden IgM rheumatoid factor (HIgM RF) in children with juvenile rheumatoid arthritis (JRA) and evaluate its clinical value Methods Immune complex including RF was separated by polyethlene glycol (PEG), and dissociated under the acid state Then the enzyme linked immunosorbent assay (ELISA) was performed to measure HIgM RF in the serum Two millilitre venous blood was collected from all enrolled subjects, including 68 JRA, 16 JRA cases of the 68 children who were at the relieved stage (relieved JRA group) and 35 healthy children who were enrolled to serve as normal controls. Results (1)Hidden IgM RF was detected in 71 4% of the JRA patients, including 80 0% with polyarticular onset disease, 71 4% with pauciarticular onset disease and 58 8% with systemic onset disease In contrast, only two (5 7%) of the control specimens were positive for the HIgM RF (2)The average value of polyarticular, pauciarticular, systemic onset group [0 71±0 10, 0 58±0 07, 0 44±0 12] were markedly higher than that of relieved group [0 19±0 05, 0 14±0 06, 0 12±0 03]( t =11 15, t =14 50, t =5 78, P <0 01) There was distinct difference of the average value between active groups and normal controls [0 13±0 06]( F =16 34, P <0 01 by the F test of multiple groups), but the result did not show significant difference between relieved groups and normal controls ( F =2 13, P >0 05 by the F test of multiple groups) The combined JRA patients with active disease had significantly higher positive rate than inactive disease(χ 2=18 160, P <0 01) There was no significant difference in positive rate between active and relieved stage in polyarticular and systemic groups (χ 2=3 516, χ 2=2 430, P >0 05), except for pauciarticular
出处
《中华儿科杂志》
CAS
CSCD
北大核心
2001年第8期469-472,共4页
Chinese Journal of Pediatrics
