类风湿因子阴性类风湿关节炎患者血清抗瓜氨酸肽或蛋白抗体、IL-10及IL-18检测分析

摘要

目的 探讨抗瓜氨酸肽或蛋白抗体(ACPAs)、白细胞介素(IL)-10和IL-18在类风湿因子(RF)阴性类风湿性关节炎(RA)诊断中的临床意义.方法 分别收集RF阴性的RA患者56例、系统性红斑狼疮(SLE)患者40例和RF阴性骨关节炎(OA)患者44例的血清,采用间接免疫荧光法检测抗角蛋白抗(AKA),采用酶联免疫吸附法检测anti-Sa、抗环瓜氨酸(CCP)多肽抗体、IL-10和IL-18.结果 AKA、anti-Sa和抗CCP抗体在RF阴性RA、SLE和OA患者中的阳性率分别为33.9%、50.0%和64.3%,抗CCP抗体阴性、RF阴性RA患者IL-10水平低于抗CCP抗体阳性、RF阴性RA患者(P＜0.05),而IL-18则相反(P＜0.05).结论 ACPAs检测有助于提高RF阴性RA患者的诊断率.早期的炎症因子失衡可能与RA早期病变有关.IL-10、IL-18检测对于抗CCP抗体阴性、RF阴性临床可疑RA患者具有一定的早期预测价值和鉴别诊断价值.%To investigate the clinical value of anti-citrullinated peptide/protein antibodies(ACPAs) ,IL-10 and IL-18 in the diagnosis of rheumatoid factor (RF) negative rheumatoid arthritis(RA). Methods Sera from 56 patients with RF negative RA,40 patients with RF negative systemic lupus erythematosus (SLE) and 44 patients with RF negative osteoarthritis (OA) were collected respectively. Indirect immunof1uorescennce assay was applied to detect AKA and enzyme linked immunosorbant assay was used to measure anti Sa antibody,anti-CCP antibody,interlukin-10 (IL-10) and interlukin-18 (IL-18). Results The positive rates of AKA,anti Sa antibody and anti-CCP antibody in patients with RF negative RA were 33.9％ ,50.0％ and 64.3％ respectively. The level of IL-10 in patients with RF negative and anti-C PP antibody negative RA was lower than that with RF negative and anti-CPP antibody positive RA(P〈0.05) ,but on the contrary,the level of IL-18 was higher(P＜0.05). Conclusion Detection of ACPAs is conducive to elevate the diagnosis rate of RF negative RA. IL-10 and IL-18 are helpful to prediction and differential diagnosis of RF and anti-CCP antibody negative RA.