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目的:通过检测幼年特发性关节炎(JIA)患者血清中的抗RA33抗体,了解抗RA33抗体与幼年特发性关节炎的临床诊断价值。方法:采用酶联免疫固相分析检测81例JIA患儿(女19名,男62名,平均年龄8.6岁,平均病程1.4年)血清中抗RA33抗体、RF,同时以55例儿童系统性红斑狼疮(SLE)等其他关节性疾病或病毒感染患者和49例健康儿童作为对照组。阴阳性结果判断均采用试剂盒推荐的临界值。结果:81例JIA患儿中抗RA33抗体阳性率为11.11%(9/81),RF阳性率为12.35%(10/81),特异性均为91.35%;JIA组与正常对照组抗RA33抗体阳性率比较有统计学意义(P<0.05),与其他关节性疾病对照组比较差异无显著性(P>0.05)。JIA组中抗RA33抗体的检出与RF无相关性(P>0.05);在JIA各亚型中抗RA33抗体主要存在于全身型和多关节型,各占33.3%和25.0%,RF则只出现于多关节型,占62.5%。两者比较有显著性差异(P<0.05)。81例JIA患儿中共有18例关节出现影像学改变,其中4例抗RA33抗体阳性(22.2%),与未发生影像学改变的JIA患儿比较无显著性差异(P>0.05)。结论:抗RA33抗体尚不能作为JIA早期诊断的新的可靠性指标,抗RA33抗体主要见于全身型和多关节型,对JIA的分型有指导意义。
OBJECTIVE: To evaluate the clinical diagnostic value of anti-RA33 antibody and juvenile idiopathic arthritis by detecting the anti-RA33 antibody in juvenile idiopathic arthritis (JIA) patients. Methods: Serum anti-RA33 antibody and RF of 81 children with JIA (female 19, male 62, mean age 8.6 years and average duration 1.4 years) were detected by enzyme-linked immunosorbent assay (ELISA), and 55 children with systemic erythema Lupus (SLE) and other other joint diseases or viral infections in 49 healthy children as control group. Positive and negative results are judged using the kit recommended threshold. Results: The positive rate of anti-RA33 antibody in 81 children with JIA was 11.11% (9/81), the positive rate of RF was 12.35% (10/81) and the specificity was 91.35%. The anti-RA33 antibody in JIA group and normal control group The positive rate was statistically significant (P <0.05), compared with other joint disease control group no significant difference (P> 0.05). In the JIA group, the detection of anti-RA33 antibody was not related to RF (P> 0.05). In the subtypes of JIA, anti-RA33 antibodies were mainly found in the systemic and polyarticular types, accounting for 33.3% and 25.0%, respectively Appears in the multi-joint type, accounting for 62.5%. There was a significant difference between the two (P <0.05). In 81 cases of JIA, there were 18 cases of joint imaging changes, of which 4 cases were positive for anti-RA33 antibody (22.2%), which showed no significant difference compared with those without JIA (P> 0.05). Conclusion: The anti-RA33 antibody can not serve as a new reliability index for the early diagnosis of JIA. Anti-RA33 antibodies are mainly found in systemic and polyarticular types, which may be helpful for the classification of JIA.