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目的探讨Ⅱ型胶原抗体在类风湿关节炎患者早期诊断和发病机制的意义。方法检测60名健康志愿者(正常对照组)、120名活动期类风湿关节炎患者(RA组),及60名其它结缔组织病患者(阳性对照组)的血清中抗Ⅱ型胶原抗体、抗环瓜氨酸多肽抗体、血沉及C反应蛋白的水平。结果(1)RA组患者血清抗Ⅱ型胶原抗体水平明显高于正常对照组,两者比较差异有统计学意义(p<0.01)。阳性对照组抗Ⅱ型胶原抗体检出率为5%(3/60),与RA组患者相比差异有统计学意义(p<0.01)。(2)早期类风湿关节炎患者抗Ⅱ型胶原抗体阳性率为66.3%(34/50),病程大于1年的患者抗体检出率为22.4%(16/70),两者比较差异有统计学意义(p<0.05)。(3)抗Ⅱ型胶原抗体阳性组,其抗环瓜氨酸多肽(CCP)抗体阳性检出率为88%(44/50);抗Ⅱ型胶原抗体阴性组,其抗环瓜氨酸多肽(CCP)抗体阳性检出率为47%(33/70),两者比较差异有统计学意义(p<0.05)。同时在抗Ⅱ型胶原蛋白阳性组C反应蛋白和血沉水平都明显高于抗Ⅱ型胶原抗体阴性组。结论抗Ⅱ型胶原抗体在类风湿关节炎的发病机制和疾病活动度中有十分重要的作用,抗Ⅱ型胶原抗体的检测对于类风湿关节炎早期的检测有非常重要的意义。
Objective To investigate the significance of type Ⅱ collagen antibody in the early diagnosis and pathogenesis of rheumatoid arthritis. Methods Serum anti-type II collagen antibody was detected in 60 healthy volunteers (normal control group), 120 active rheumatoid arthritis patients (RA group) and 60 other connective tissue disease patients (positive control group) Cyclic citrullinated peptide antibody, erythrocyte sedimentation rate and C-reactive protein levels. Results (1) The levels of serum anti-type II collagen antibody in RA patients were significantly higher than those in normal controls (P <0.01). The detection rate of anti-type Ⅱ collagen antibody in positive control group was 5% (3/60), which was significantly different from that in RA group (p <0.01). (2) The positive rate of anti-type II collagen antibody in patients with early-stage rheumatoid arthritis was 66.3% (34/50), and the rate of antibody detection was 22.4% (16/70) in patients with the course of more than 1 year. There was statistical difference between the two Significance (p <0.05). (3) The positive rate of anti-cyclic citrullinated peptide (CCP) antibody was 88% (44/50) in anti-type II collagen antibody positive group. The anti-type II collagen antibody negative group had anti-cyclic citrullinated peptide (CCP) antibody positive rate was 47% (33/70), the difference was statistically significant (p <0.05). At the same time, the levels of C-reactive protein and erythrocyte sedimentation rate in anti-type II collagen positive group were significantly higher than those in anti-type II collagen antibody negative group. Conclusion Anti-type Ⅱ collagen antibody plays an important role in the pathogenesis and disease activity of rheumatoid arthritis. The detection of anti-type Ⅱ collagen antibody is very important for the early detection of rheumatoid arthritis.