论文部分内容阅读
目的比较分析幼年特发性关节炎(JIA)和成人类风湿关节炎(RA)患儿血清抗环瓜氨酸肽(CCP)抗体水平,探讨抗CCP抗体在JIA诊断中的价值和意义。方法 2009年2-12月首都儿科研究所风湿免疫科确诊的JIA患儿72例。男33例,女39例;年龄(7.58±3.93)岁,全身型29例,少关节型27例,多关节型16例。同期在中国人民解放军总医院风湿科确诊的RA患者共65例。男14例,女51例;年龄(47.38±14.28)岁。健康对照组22例,为同期健康查体儿童。男10例,女12例;年龄(14.10±0.38)岁。选用英国Axis-shield Diagnostics Limit公司、德国欧蒙公司和上海富莼科芯公司生产的CCP抗体ELISA检测试剂盒,分别检测JIA患儿、RA患者和健康儿童血清CCP抗体水平。结果英国Axis-shield Diagnostics Limit公司检测JIA患儿血清抗CCP抗体的阳性率为12.5%(9/72例),RA患者血清阳性率高达73.85%(48/65例),健康对照组无阳性(0/22例)。RA患者血清抗CCP抗体阳性率显著高于JIA患儿(P<0.01),其中JIA组中多关节型阳性率31.25%(5/16例),少关节型阳性率14.8%(4/23例),全身型阳性率为0(0/29例),差异有统计学意义(P<0.001)。另2家公司试剂盒检测结果JIA患儿血清抗CCP抗体的阳性率为15.3%(11/72例),RA患者血清阳性率为73.85%(48/65例),健康儿童无阳性。RA患者血清和健康儿童血清结果3家公司检测试剂盒完全一致。JIA患儿3种抗CCP抗体试剂盒检测结果之间差异无统计学意义(P>0.05)。结论 ELISA方法检测血清抗CCP抗体水平较为稳定可靠,抗CCP抗体在JIA患儿中血清阳性率低于成人RA,抗CCP抗体在JIA各亚型分布差异显著,抗CCP抗体与多关节型相关。
Objective To compare the serum anti-cyclic citrullinated peptide (CCP) antibody levels in children with juvenile idiopathic arthritis (JIA) and adult rheumatoid arthritis (RA), and to explore the value and significance of anti-CCP antibodies in the diagnosis of JIA. Methods Twenty-two children with JIA diagnosed by Department of Rheumatology, Capital Institute of Pediatrics from January to December in 2009 were retrospectively analyzed. There were 33 males and 39 females, with a mean age of (7.58 ± 3.93) years, 29 with whole body type, 27 with less joint type and 16 with multi-joint type. The same period in the People’s Liberation Army General Hospital Rheumatology diagnosed RA patients a total of 65 cases. There were 14 males and 51 females, with a mean age of 47.38 ± 14.28 years. 22 cases of healthy control group, for the same period health check-up children. 10 males and 12 females; age (14.10 ± 0.38) years old. CCP Antibody ELISA Assay Kit manufactured by Axis-shield Diagnostics Limit Company in England, Ou Meng Company in Germany and Shanghai Fufang Keystone Co. was used to detect serum CCP antibody level in children with JIA, RA and healthy children respectively. Results The positive rate of Serum anti-CCP antibody in British children with JIA was 12.5% (9/72). The positive rate of Serum in RA patients was 73.85% (48/65), while the positive control group was not ( 0/22 cases). The positive rate of anti-CCP antibody in patients with RA was significantly higher than that in children with JIA (P <0.01). The positive rate of multi-joint type in JIA group was 31.25% (5/16 cases) and the rate of less joint type was 14.8% (4/23 cases ), The positive rate of the whole body was 0 (0/29 cases), the difference was statistically significant (P <0.001). In the other two companies, the positive rate of serum anti-CCP antibody was 15.3% (11/72) in patients with JIA and 73.85% (48/65) in RA patients, but no positive in healthy children. RA patient serum and healthy children serum results of three companies exactly the same test kit. There was no significant difference between the three anti-CCP antibody kits in JIA children (P> 0.05). Conclusion The serum level of anti-CCP antibody by ELISA is stable and reliable. The positive rate of anti-CCP antibody in children with JIA is lower than that of adult RA. The distribution of anti-CCP antibody in each subtype of JIA is significantly different. The anti-CCP antibody is associated with polyarthritis.