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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。
Objective To investigate the significance of detecting anti-cyclic citrullinated peptide (CCP) antibody in the diagnosis of juvenile idiopathic arthritis (JIA). Methods Sixty-six children with JIA, 11 children with other rheumatic diseases and 29 normal children were enrolled in Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology from 2002-06-2004-08. Serum was detected by enzyme linked immunosorbent assay (ELISA) Anti-CCP antibody, anti-CCP antibody in each group were compared, and to explore the significance of anti-CCP antibody in the diagnosis of JIA. Results The positive rate of anti-CCP antibody in 66 children with JIA was 16.7% (11/66). The positive rate of rheumatoid factor (RF) positive polyarthritis was 57.1% (4/7), RF negative The joint type was 19.0% (4/21), the less articular type was 23.1% (3/13). There were 22 cases of systemic and 3 cases of children with ERA, anti-CCP antibodies Negative. Anti-CCP antibodies were also negative in other rheumatic children and controls. The positive rate of anti-CCP in JIA group and normal control group was statistically significant (P <0.05), in which polyarthrosis and less articular type were also statistically significant compared with the normal control group, while other subtypes and normal control group No statistical significance. Conclusion Anti-CCP antibody can not serve as a new reliable serological indicator for early diagnosis of JIA. Anti-CCP antibodies are mainly seen in the JIA multi-joint type and less joint type, speculated that anti-CCP antibody JIA classification and prognosis may have guiding significance.