1 抗Ⅱ型胶原抗体的检测及其在类风湿关节炎中的意义【摘要】目的了解抗Ⅱ型胶原抗体在类风湿关节炎(RA) 中的临床意义。方法以改进的酶联免疫吸附法(ELISA) 检测 179例RA 患者和 171 例其他风湿病患者的血清 IgG 型抗天然及抗变性Ⅱ型胶原抗体水平。结果 RA 患者抗天然和抗变性Ⅱ型胶原抗体阳性率各为 % 和 % ,早期RA 患者各为 % 和 % 。其他风湿病患者中各为 % 和 % , 健康人二者均为 % 。抗天然Ⅱ型胶原抗体阳性 RA 患者类风湿因子检出率、患者对病情活动性评价高于阴性组() 。抗变性Ⅱ型胶原抗体和抗天然Ⅱ型胶原抗体同时阳性 RA 患者的 CRP 平均水平较高。结论抗天然Ⅱ型胶原抗体可以作为 RA 的一个辅助诊断指标。抗天然与抗变性Ⅱ型胶原抗体的检测有助于判断 RA 病情活动性。 Anti-type Ⅱ collagen antibodies in rheumatoid arthritis 2 【 Abstract 】 Objective To investigate the clinical significance of anti-type- Ⅱ-collagens antibody in rheumatoid arthritis (RA).Method Serum IgG antibodies to native and denatured type Ⅱ collagens (anti-nc Ⅱ and anti-dc Ⅱ) were detected in 179 patients with RA by an improved enzyme linked immunosorbent assay (ELISA),and thEir clinical significance was analysed with corresponding clinical In RA,the positive rates of anti-nc Ⅱ and anti-dc Ⅱ were % and %;in early RA were % and %, other rheumatic diseases the positive rates were % and %,respectively and were both % in healthy -nc Ⅱ positive RA showed higher prevalence rate of RF and higher scores of patient ′s global assessment of disease activity (P ). The presence of anti-nc Ⅱ and anti-dc Ⅱ itantly was associated with high CRP level in RA Anti-nc Ⅱ could serve asa supplemental parameter in diagnosing RA and together with anti-dc Ⅱ may help evaluate the disease activity. 【 Key words 】 Rheumatoid arthritis; Anti-type Ⅱ 3 collagen antibody; Enzyme-linked immunosorbent assay; C-reactive protEIn 抗Ⅱ型胶原抗体(antibodies to type Ⅱ collagen) 与类风湿关节炎(RA) 病情活动性、严重性的关系目前仍有争论。本研究参照 Fujii 等[ 1 ]提出的实验条件检测 179 例RA 患者、 171 例其他风湿病和 118 名正常人血清的抗Ⅱ型胶原抗体,探讨其在 RA 中的临床意义。结果报告如下。 1 资料与方法 一般资料 病人组:为 1994 年9 月至 1999 年3 月在汕头大学医学院第一附属医院风湿科住院、门诊、随访的 RA 患者,共 179 例,全部符合 1987 年美国风湿病协会(ARA) 的 RA 分类标准[ 2] 。其中男性 53 例,女性 126 例,年龄 17~ 76 岁,平均 岁。其中病程 1 年之内, X 线未出现 4 明显骨质破坏者( 以下简称早期病例)30 例。 对照组:共 289 例,分为两