中国实用儿科杂志

中国实用儿科杂志

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抗环瓜氨酸肽抗体在幼年特发性关节炎诊断中的意义

康闽，王宏伟，程佩萱，施虹   

  1. 华中科技大学同济医学院同济医院儿科， 湖北武汉 430030
  • 收稿日期:2005-11-15 修回日期:2006-03-26 出版日期:2006-06-06 发布日期:2006-06-06

The clinical significance of anticyclic citrullinated peptide antibodies in juvenile idiopathic arthritis.

Kang Min,Wang Hongwei,Cheng Peixuan，et al.   

  1. Department of Pediatrics,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430030 China
  • Received:2005-11-15 Revised:2006-03-26 Online:2006-06-06 Published:2006-06-06

摘要： 目的探讨抗环瓜氨酸肽(CCP)抗体检测在幼年特发性关节炎(JIA)诊断中的意义。 方法对华中科技大学同济医学院同济医院2002-06—2004-08收治的JIA患儿66例、其他风湿病患儿11例及正常儿童29名，运用酶联免疫吸附试验(ELISA)方法检测血清中抗CCP抗体，比较各组抗CCP抗体阳性率，并探讨抗CCP抗体在诊断JIA中的意义。 结果66例JIA患儿中抗CCP抗体阳性率为167%(11/66)，其中类风湿因子(RF)阳性多关节型阳性率为571%(4/7)，RF阴性多关节型为190%(4/21)、少关节型为231%(3/13)，22例全身型和3例附着点炎相关关节炎(ERA)患儿，抗CCP抗体均为阴性。其他风湿病患儿组和对照组抗CCP抗体亦为阴性。JIA组与正常对照组抗CCP阳性率比较有统计学意义(P<005)，其中多关节型及少关节型与正常对照组比较亦有统计学意义，而其他亚型与正常对照组比较无统计学意义。 结论抗CCP抗体尚不能作为JIA早期诊断的新的可靠的血清学指标。抗CCP抗体主要见于JIA多关节型和少关节型，推测抗CCP抗体对JIA分型及预后评价可能有指导意义。

关键词: 抗环瓜氨酸肽抗体, 幼年特发性关节炎, 酶联免疫吸附试验

Abstract: AbstractObjectiveTo investigate the clinical significance of antiCCP antibodies in juvenile idiopathic arthritis (JIA). MethodsFrom June 2002 to Aug.2004,enzymelinked immunosorbent assay(ELISA)was used for the detection of antiCCP antibody of 106 children (including 66 cases of JIA，11 other rheumatoid disease patients and 29 healthy children) to compare the positive rate of the groups. ResultsAntiCCP antibody was found in 11/66 (167%) JIA patients，including 4/7 patients with RFpositive polyarthritis,4/21 with RFnegative polyarthritis and 3/13 with oligoarthritis.None of the systemic onset and enthesitisrelated arthritis patients was positive for antiCCP antibody,Neither was the group of other rheuamatoid disease patients and 29 healthy children.There showed significant difference between JIA patients and control children(P<005),so did polyarthritis and oligoarthritis subtype compared with control children. ConclusionAntiCCP antibody cannot yet be considered as an important serological marker for the early diagnosis of JIA.AntiCCP antibody shows relatively higher positive rate in JIA patients of polyarthritis and oligoarthritis subtype,which indicates antiCCP antibodies may have an important role in JIA typing and prognosis of JIA.

Key words: Juvenile idiopathic arthritis, ELISA