论文标题:抗CⅡ抗体在类风湿关节炎中的临床意义以及与TNF-α和IL-6相关性的研究
Study on the Clinical Significance of Anti-collagen Type Ⅱ Antibodies in Patients with Rheumatoid Arthritis and the Relationship between TNF-α and IL-6 and Antibodies
论文作者
论文导师 刘宗平；栗占国,论文学位 硕士,论文专业 临床兽医学
论文单位 扬州大学,点击次数 112,论文页数 55页File Size648K
2006-05-01论文网 http://www.lw23.com/lunwen_4974442/
Anti-collagen typeⅡ; Rheumatoid arthritis; Inflammatory cytokine
为了研究抗Ⅱ型胶原(CⅡ)抗体在类风湿关节炎(RA)中的阳性率以及临床意义,本研究采用ELISA法检测,Western Blot法及双向免疫扩散法验证抗CⅡ抗体在RA与疾病对照组血清中的阳性率,同时,分析其与患者的临床特点、实验室指标的相关性及其临床意义。结果,抗CⅡ抗体在RA中的敏感性和特异性分别为37.8%和76.4%,在其他风湿病组及健康对照组中的阳性率分别为:SLE 38.1%,pSS 31.3%,OA25%,健康对照11.1%。抗CⅡ抗体在RA中的阳性率与其他风湿病组比较,无统计学差异,与健康对照组比较有统计学差异(P<0.05),提示抗CⅡ抗体在其他风湿病中也有一定的检出率。抗CⅡ抗体阳性组患者的类风湿因子滴度与抗CⅡ抗体阴性组比较,差异显著(P<0.05),而抗CⅡ抗体阳性组患者在年龄、性别、临床表现、血常规等方面与阴性组比较,无统计学差异(P>0.05)。但抗CⅡ抗体在CCP、HRF、RA33、AKA、APF等抗体阴性血清中有很高的阳性率,提示抗天然CⅡ抗体可以作为RA的一个临床辅助诊断指标。 另外,多项研究表明,细胞因子在RA发病过程中起重要作用,为了探讨细胞因子与RA患者临床症状和实验室指标的相互关系以及与抗CⅡ抗体的相关性,本文检测了74例RA患者以及60例正常对照组血清中的TNF-α、IL-6水平。TNF-α在RA中的水平为754.36±214.12ng/L, IL-6为1225.58±876ng/L,与正常对照组比较,差异极显著(P<0.01),抗CⅡ抗体与TNF-α、IL-6相关,提示抗CⅡ抗体可能是引起RA关节炎症反应的抗体。 因此,在类风湿关节炎病人中开展TNF-α、IL-6等细胞因子的检测,可能有助于临床医师判断病情的活动程度。
To determine the positivity and clinical significance of antibodies to typeⅡcollagen (CⅡ).The anti-CⅡantibodies were measured by ELISA and demonstrated by Western Blot and double immunol diffusion in sera from patients with rheumatoid arthritis (RA) and other rheumatatic disease. The laboratory and clinical features were analyzed retrospectively through clinical database. The sensitivity and specificity of the anti-CⅡantibodies were 37.8% and 76.4% in patients with RA. Prevalences of the anti-CⅡantibodies were 38.1%, 31.3%, 25%, 11.1% in SLE, pSS, OA, Healthy control, respectively. No statistical difference was found between RA and other group. The results suggest that anti-CⅡantibodies could be assayed other than RA. The titers of RF in anti-CⅡantibodies positive patients were significant higher than patients with negative anti-CⅡantibodies(P<0.05). There were no statistical difference among age, sex, clinical manifestation and blood rutine examination in anti-CⅡantibodies positive patients and negative patients. The positive rate of the anti-CⅡantibodies were also higher in patients with RA than patients with negative CCP, HRF, RA33, AKA and APF. The results suggest that anti-collagen typeⅡantibodies could be a method of diagnosis of RA. Otherwise, there were several studies demonstrated that cytokines play an important role in the pathogenesis of RA. To study the correlation between the cytokine and clinical and laboratory indices and to determine the relationship between the anti-CⅡantibodies and cytokine in patients with RA, we measured the levels of TNF-αand IL-6 in 74 RA and 60 healthy individuals. The titers of TNF-αand IL-6 were 754.36±214.12ng/L, 1225.58±876ng/L, respectively. The significant difference was found between the levels of TNF-αand IL-6 in RA patients and normal subjects (P<0.01). There were association between the anti-CⅡantibodies and TNF-αand IL-6, suggest that anti-CⅡantibodies may be antibodies provoking inflammatory responses in the joint in RA. Hence, assaying TNF-αand IL-6 may be of help in the diagnosis of the degree of disease activity.
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