血清蛋白电泳在类风湿性关节炎诊治中的应用

摘要

目的 分析血清蛋白电泳在类风湿性关节炎(RA)中的作用及临床意义.方法 对186例RA患者(实验组)和75例健康成人(对照组)的血清进行血清蛋白电泳；同时进行血清总蛋白、白蛋白、球蛋白,RF、CRP及免疫球蛋白(IgA、IgM、IgG)含量检测；并对186例RA患者进行一年的随访,分为活动期和非活动期2组,比较2组血清蛋白电泳和免疫球蛋白含量变化.结果RA组和对照组血清蛋白电泳谱比较:白蛋白显著降低,a1球蛋白、a2球蛋白和γ球蛋白显著增高,RA患者血清RF、CRP及免疫球蛋白含量明显高于对照组差异均有统计学意义(P＜0.01)；随访期间RA活动期较RA非活动期患者血清蛋白电泳谱为白蛋白明显降低,α1球蛋白、α2球蛋白及y球蛋白均明显增高和免疫球蛋白含量均有显著性增高,差异均有统计学意义(P＜0.05和P＜ 0.01).结论 对于RA患者,应进行血清蛋白电泳与血清蛋白含量及免疫球蛋白联合测定,对其诊断、治疗、监测及预后具有重要的临床意义.%Objective To analyse the role and clinical significance of serum protein electrophoresis in rheumatoid arthritis (RA). Methods 186 rheumatoid arthritis cases (study group) and 75 healthy adults underwent serum protein electrophoresis (control group). Serum level of total protein,albumin,globulin,rheumatoid factor(RF),C-reactive protein(CRP) and immunoglobulin (IgA,IgM,IgG) were detected at the same time. The 186 RA patients were followed up for one year and were divided into active stage group and unactive stage group. Serum protein electrophoresis results and immunoglobulin levels were compared between the two groups. Results Compared with the control group,the study group had significantly lower albumin level and significantly higher α1 globulin,α2 globulin and γglobulin levels(P< 0.01). Serum RF,CRP and immunoglobulin levels in the study group were significantly higher than those in the control group (P < 0.01). During the follow-up period,serum albumin was significantly reduced in RA patients at active stage,while serum α1 globulin,α2 globulin,γ globulin and immunoglobulin levels were significantly increased (P < 0.05 or P < 0.01). Conclusion Combination of serum protein electrophoresis and serum protein measurement in RA patients is very important for the diagnosis,treatment,monitoring and prognosis judgment.