目的 分析类风湿关节炎患者血清中抗肽酰基精氨酸脱亚胺酶4(PADI4)抗体水平,探讨其对类风湿关节炎的诊断和评估意义.方法 采用酶联免疫吸附实验检测类风湿关节炎患者组(96例)、非类风湿关节炎患者组(170例)及健康对照组(45例)血清中抗PADI4抗体水平,分析该指标在三组间的差异及其与RA患者临床指标、相关实验室指标及肺间质纤维化、双手关节X线分期等指标的关系.结果① RA患者血清中抗PADI4抗体的平均浓度为10.91U·L-1,阳性率为42.7%,均高于非RA患者组和健康对照组(P<0.05).②相关性分析显示抗PADI4抗体水平与抗CCP抗体、RF、AKA明显相关(P<0.05).③抗PADI4抗体阳性组ESR、CRP、IgG、IgA、IgM、C3、C4水平、DAS28评分、肺间质改变发生率、X线Ⅲ~Ⅳ期改变均明显高于抗PADI4抗体阴性组(P<0.05).④RA患者高活动组血清抗PADI4抗体水平与非(低)活动组比较,差异有统计学意义(P<0.05).结论抗PADI4抗体是一种新的对RA有诊断价值的血清学指标,并且与疾病活动及病情严重程度相关,可能有助于RF、抗CCP抗体、AKA阴性RA的诊断.%Objective To explore the value of serum anti - peptidylarginine deiminase enzyme 4( PADI4 ) antibodies in diagnosis and estimation of RA. Methods Anti - PADI4 antibodies levels in rheumatoid arthritis ( RA ) group, other rheumatic group , and the healthy control group were detected with Enzyme Linked Immu-nosorbent assay( ELISA ). Results The prevalence of anti - PADI4 antibody in RA patients ( 42. 7% ) was higher than that in other rheumatic diseases and healthy controls( P < 0. 05 ). Anti - PADI4 antibodies were significantly associated with anti - cyclic citrallinated peptide( CCP ) antibodies, AKA and rheumatoid factor ( RF ) . The levels of serum ESR, CRP, IgG, IgA, IgM and DAS28 score in anti - PADI4 antibody positive group were higher than those in negative group. Conclusion The results suggest that anti - PADI4 antibody has higher diagnostic value in RA, especially in RF - negative, AKA - negative, and anti - CCP antibodies -negative RA. Anti - PADI4 antibody is associated with the activity and severity of the disease. PADI4 may be a pathogenic antigen for RA and play an important role in RA pathogenesis and pathological processes.
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