原发性干燥综合症抗CCP抗体与非侵蚀性滑膜炎相关
发表者：整理
日期：2015-03-11
浏览次数：888
评论次数：0
摘要：本研究目的是了解原发性干燥综合症的抗环瓜氨酸肽（CCP）抗体的阳性率及其与临床和试验室资料间的关联。
方法：我们分析了155例原发性干燥综合症患者的临床和和血清学资料，其中有14例患者因符合ACR关于类风湿性关节炎诊断标准而被剔除，剩下的141例患者（男27例，女114例；年龄39－60岁，平均48岁）进行滑膜炎（1个或多个关节的客观肿胀）和腺体外症状的评估。使用第二代商用酶联免疫吸附试验检测抗CCP抗体，比浊法测定IgM－RF。
结果：14例患者(占9.9%)出现中高水平的抗循环瓜氨酸肽，94例患者（66.7%）的类风湿因子为阳性，81例患者（54.7%）出现腺体外受累，44例患者（31.2%）出现X线片下无侵蚀的滑膜炎。抗CCP抗体的出现与滑膜炎有紧密的关联（P<0.001），但与腺体外受累无关（P=0.77）。多参数分析证实了抗CCP抗体与滑膜炎发生率增高有关（抗CCP抗体阳性与阴性的风险比为7.611，95%的可信区间为1.475－74.870；P = 0.010） 。
结论： 仅有少数原发性干燥综合症患者的抗CCP抗体阳性，这似乎与滑膜炎的发生紧密相关。因此，原发性干燥综合症出现抗CCP抗体阳性似乎提示将来可能发展为类风湿关节炎或出现滑膜组织的炎性病变。
附原文：Abstract Introduction The purpose of this study was to investigate the prevalence of cyclic citrullinated peptide antibodies (anti-CCP) in patients with primary Sjögren syndrome (pSS) and its correlation with clinical and laboratory data. Methods We analysed the clinical and serological data of 155 consecutive patients with pSS. Among these, 14 were excluded due to fulfillment of American College of Rheumatology criteria for rheumatoid arthritis (RA). So, 141 patients (27 males and 114 females; mean age 48 years, range 39 to 60) were clinically assessed for the presence of synovitis (objective swelling of one or more joints) and extra-glandular involvement. The anti-CCP antibodies were tested using a commercially available second-generation enzyme-linked immunosorbent assay. IgM rheumatoid factor (RF) was determined by nephelometry. Results Fourteen patients (9.9%) had moderate to high levels of anti-CCP, and 94 (66.7%) were positive for RF. Eighty-one (57.4%) showed extra-glandular involvement, and 44 (31.2%) had synovitis without any radiographic sign of erosion. There was a close correlation between the presence of anti-CCP and synovitis (P < 0.001) but no association between anti-CCP and extra-glandular involvement (P = 0.77). Multivariate analysis confirmed the association between anti-CCP and an increased prevalence of synovitis (prevalence odds ratio for positive versus negative anti-CCP status 7.611, 95% confidence interval 1.475 to 74.870; P = 0.010). Conclusion Only a minority of patients with pSS are anti-CCP-positive, which seems to be closely associated with the prevalence of synovitis. Anti-CCP positivity in patients with pSS therefore may be a predictor of future progress to RA or an expression of the inflammatory process of synovial tissue.
引自：Atzeni F, Sarzi-Puttini P, Lama N, et al.Anti-cyclic citrullinated peptide antibodies in primary Sjögren syndrome may be associated with non-erosive synovitis. Arthritis Res Ther. 2008; 10(3): R51. （注：干燥综合症病人或亲属可加QQ群交流，群号： 118194945 ，本网站站长私人微信号： ssgzz88 ）
方法：我们分析了155例原发性干燥综合症患者的临床和和血清学资料，其中有14例患者因符合ACR关于类风湿性关节炎诊断标准而被剔除，剩下的141例患者（男27例，女114例；年龄39－60岁，平均48岁）进行滑膜炎（1个或多个关节的客观肿胀）和腺体外症状的评估。使用第二代商用酶联免疫吸附试验检测抗CCP抗体，比浊法测定IgM－RF。
结果：14例患者(占9.9%)出现中高水平的抗循环瓜氨酸肽，94例患者（66.7%）的类风湿因子为阳性，81例患者（54.7%）出现腺体外受累，44例患者（31.2%）出现X线片下无侵蚀的滑膜炎。抗CCP抗体的出现与滑膜炎有紧密的关联（P<0.001），但与腺体外受累无关（P=0.77）。多参数分析证实了抗CCP抗体与滑膜炎发生率增高有关（抗CCP抗体阳性与阴性的风险比为7.611，95%的可信区间为1.475－74.870；P = 0.010） 。
结论： 仅有少数原发性干燥综合症患者的抗CCP抗体阳性，这似乎与滑膜炎的发生紧密相关。因此，原发性干燥综合症出现抗CCP抗体阳性似乎提示将来可能发展为类风湿关节炎或出现滑膜组织的炎性病变。
附原文：Abstract Introduction The purpose of this study was to investigate the prevalence of cyclic citrullinated peptide antibodies (anti-CCP) in patients with primary Sjögren syndrome (pSS) and its correlation with clinical and laboratory data. Methods We analysed the clinical and serological data of 155 consecutive patients with pSS. Among these, 14 were excluded due to fulfillment of American College of Rheumatology criteria for rheumatoid arthritis (RA). So, 141 patients (27 males and 114 females; mean age 48 years, range 39 to 60) were clinically assessed for the presence of synovitis (objective swelling of one or more joints) and extra-glandular involvement. The anti-CCP antibodies were tested using a commercially available second-generation enzyme-linked immunosorbent assay. IgM rheumatoid factor (RF) was determined by nephelometry. Results Fourteen patients (9.9%) had moderate to high levels of anti-CCP, and 94 (66.7%) were positive for RF. Eighty-one (57.4%) showed extra-glandular involvement, and 44 (31.2%) had synovitis without any radiographic sign of erosion. There was a close correlation between the presence of anti-CCP and synovitis (P < 0.001) but no association between anti-CCP and extra-glandular involvement (P = 0.77). Multivariate analysis confirmed the association between anti-CCP and an increased prevalence of synovitis (prevalence odds ratio for positive versus negative anti-CCP status 7.611, 95% confidence interval 1.475 to 74.870; P = 0.010). Conclusion Only a minority of patients with pSS are anti-CCP-positive, which seems to be closely associated with the prevalence of synovitis. Anti-CCP positivity in patients with pSS therefore may be a predictor of future progress to RA or an expression of the inflammatory process of synovial tissue.
引自：Atzeni F, Sarzi-Puttini P, Lama N, et al.Anti-cyclic citrullinated peptide antibodies in primary Sjögren syndrome may be associated with non-erosive synovitis. Arthritis Res Ther. 2008; 10(3): R51. （注：干燥综合症病人或亲属可加QQ群交流，群号： 118194945 ，本网站站长私人微信号： ssgzz88 ）