葡萄糖-6-磷酸异构酶早期诊断类风湿关节炎的临床意义

目的：探讨血清葡萄糖6-磷酸异构酶（GPI）早期诊断类风湿关节炎（RA）的临床意义。方法：用ELISA法检测105例RA组、51例风湿病组、42例非风湿病组及40例健康对照组的血清GPI浓度，其中RA组分为早期组和中晚期组。同时收集RA患者类风湿因子（RF）、血沉（EsR）、免疫球蛋白、C-反应蛋白（CRP）、补体（C3、C4）、关节炎部位数等相关临床指标。结果：GPI对早期RA和中晚期RA诊断的敏感性分别为70．03％，和79．41％；特异性分别为89．89％和90．91％；二者敏感性、特异性比较均无显著差异；在RA患者中，GPI结果与RF、CRP、ESR、IgA、IgG、关节炎部位数均有相关性（P〈0．05），与c3、C4、IgM无相关性；RF诊断RA的敏感性80．95％，特异性为78．19％，与GPI比较，二者敏感性无显著差异，特异性有差异（P〈0．05），二者同时检测诊断RA的敏感性为69．52％，特异性达93．99％。结论：GPI诊断早期RA具有较好的敏感性和特异性，与RF联合检测对RA诊断具有很高的特异性，且可能成为判断RA病情活动的指标之一。

Early Diagnostic Value of Glucose-6-phosphate isomerase for the Patients with Rheumatoid Arthritis

Objective： To investigate the early diagnostic value of glucose-6-Phosphate isomerase（GPI） expression in patients with rheumatoid arthritis （RA）. Methods： ELISA was used to measure the serum concentration of GPI in patients with RA and other control groups. RA group was divided into early RA group and middle-late RA group. Other immune markers were also assayed in RA patients. Results： The sensitivity of GPI in early RA patients and advanced RA patients were 70.03% and 79.41% separately, and the specificity. was 89.89 % and 90.91% separately. There was no statistical significance of GPI in the early RA group and late RA group. Meanwhile, the concentrations of GPI were positive in patients with rheumatoid factor or ESR or arthritis or CRP or IgA （P〈0.05）. The sensitivity and specificity of RF in RA patients are 80.95% and 78.19%. There was statistical significance of the specificity of GPI compared with RF in RA patients. The sensitivity and specificity was 69.52% and 93.99% when GPI and RF were positive. Conclusions： Measuring the serum concentration of GPI shows important clinical significance in diagnosing the early RA. There was high specificity when GPI and RF were positive. And GPI may be a new marker for accessing its activity.