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目的检测类风湿关节炎(rheumatoid arthritis,RA)患者血清与关节滑液抗肽酰基精氨酸脱亚氨酶(peptidy-larginine deiminase type4,PADI4)抗体4水平,探讨其在RA中的临床意义。方法采用ELISA法检测RA患者60例、其他风湿病组40例及健康对照组40例的血清抗PADI4抗体水平,比较其与RA疾病活动指数DAS28评分、血清类风湿因子(rheumatoid factor,RF)、C反应蛋白(c-reactive protein,CRP)、血沉(erythrocyte sedimentation rate,ESR)、抗CCP抗体等指标的相关关系;测定关节滑液抗PADI4水平并研究与血清抗PADI4的相关性;对RA组治疗后进行血清抗PADI4水平测定。结果 RA组血清抗PADI4水平高于其他风湿组及对照组(P值均﹤0.05);抗PADI4水平与DAS28评分和抗CCP具有相关性(P﹤0.01);RA组关节滑液抗PADI4水平高于血清水平(P﹤0.01),且与血清水平显著正相关(r=0.67,P﹤0.01);治疗后血清抗PADI4水平与治疗前差异有统计学意义(P﹤0.01)。结论 RA患者血清及关节滑液中存在特异性的抗PADI4抗体,抗PADI4抗体与疾病活动及病情严重程度相关,是RA疾病进展与改善的血清学指标。PADI4可能在RA的发病中起重要作用。
Objective To detect the levels of anti-peptidy-larginine deiminase type 4 (PADI4) antibody in serum and synovial fluid of patients with rheumatoid arthritis (RA) and to explore its clinical significance in RA. Methods Serum levels of anti-PADI4 antibody in 60 patients with RA, 40 patients with other rheumatic diseases and 40 healthy controls were measured by ELISA. The serum levels of anti-PADI4 antibodies were compared with DAS28 score, rheumatoid factor (RF) C reactive protein (CRP), erythrocyte sedimentation rate (ESR), anti-CCP antibody and other indicators of correlation; determination of synovial fluid anti-PADI4 levels and serum anti-PADI4 correlation; RA group After treatment serum anti-PADI4 levels were measured. Results The level of serum anti-PADI4 in RA group was higher than that in other rheumatic and control groups (P <0.05). The level of anti-PADI4 was correlated with DAS28 score and anti-CCP (P <0.01) (P <0.01), and there was a significant positive correlation with serum level (r = 0.67, P <0.01). The level of anti-PADI4 in serum after treatment was significantly different from that before treatment (P <0.01). Conclusion Anti-PADI4 antibodies exist in the serum and synovial fluid of RA patients. Anti-PADI4 antibody is correlated with disease activity and severity of disease, and is a serological indicator of the progression and improvement of RA disease. PADI4 may play an important role in the pathogenesis of RA.