摘要
目的探讨抗环瓜氨酸肽(CCP)抗体在混合性结缔组织病(MCTD)中的临床价值。方法采用酶联免疫吸附法分别检测57例MCTD、78例类风湿关节炎(RA)、64例系统性红斑狼疮(SLE)、56例多发性肌炎/皮肌炎(PM/DM)、53例干燥综合征(SS)、33例系统性硬化病(SSc)患者血清的抗CCP抗体水平,分析比较抗CCP抗体与MCTD各种临床特征的关系。结果抗CCP抗体在RA、MCTD、符合RA诊断标准的MCTD、SLE、PM/DM、SS、SSc患者中的阳性率分别为87.5%、15.8%、57.1%、14.1%、15.2%、18.9%、9.1%,其中RA组及符合RA诊断标准的MCTD组与其它组相比差异有统计学意义(P<0.05);在抗CCP抗体阳性的MCTD患者中,RA样表现及SS样表现的发生率高于抗CCP抗体阴性的MCTD患者(P<0.05);在符合RA诊断标准的MCTD患者中,RA相关症状、弥漫性硬化及抗CCP抗体阳性的发生率高于不符合RA诊断标准的MCTD患者(P<0.01);符合RA诊断标准的MCTD与抗CCP抗体阳性但不符合RA标准的MCTD的病谱特点有显著差异。结论高滴度抗CCP抗体合并RA、SLE和SSc的临床特征提示MCTD患者可能出现侵蚀性关节炎。
Objective To determine the clinical significance of anti-cyclic citrullinated peptide antibody（anti-CCP） in mixed connective tissue diseases（MCTD）.Methods Enzyme linked immunosorbent assay was performed to detect anti-CCP in 57 patients with MCTD,78 with rheumatoid arthritis（RA）,64 with systemic lupus erythematosus（SLE）,56 with polymyositis/dermatomyositis（PM/DM）,53 with sjogren syndrome（SS） and with 33 systemic sclerosis（SSc）.The association between anti-CCP and clinical features of MCTD was analysed.Results Anti-CCP was detected in 87.5% RA cases,15.8% MCTD cases,57.1% MCTD with RA cases,14.1% SLE cases,15.2% PM/DM cases,18.9% SS cases and 9.1% SSc cases.Patients with RA（or MCTD with RA） were more likely to be anti-CCP positive than those without RA（P〈0.05）.The MCTD patients with positive anti-CCP had higher prevalence of RA and SS related manifestations than those MCTD patients with negative anti-CCP（P〈0.05）.The MCTD patients with RA had higher prevalence of RA-related symptoms,diffuse sclerosis and positive anti-CCP than those MCTD patients without RA（P〈0.01）.Significant deviation of disease spectrum was found in the MCTD patients with RA compared with the anti-CCP positive MCTD patients without RA.Conclusion High titer of anti-CCP in combination with RA,SLE and SSc manifestations in MCTD patients can be an indicator of erosive arthritis.
出处
《四川大学学报（医学版）》
CAS
CSCD
北大核心
2011年第3期374-377,共4页
Journal of Sichuan University(Medical Sciences)
基金
国家自然科学基金(批准号30901339)资助
关键词
抗环瓜氨酸肽抗体
混合性结缔组织病
类风湿关节炎
Anti-cyclic citrullinated peptide antibody Mixed connective tissue disease Rheumatoid arthritis
