血清抗角蛋白抗体谱测定对类风湿关节炎骨侵蚀的预测价值

目的：探讨血清抗角蛋白抗体谱对类风湿关节炎预后的判断价值。方法：选择早期、活动性类风湿关节炎患者82例（病程≤6个月）,分为病例组（抗角蛋白抗体谱阳性组,n=39）和对照组（抗角蛋白抗体谱阴性组,n=43）,均给予相同的治疗方案,在治疗前、治疗后12个月、治疗后24个月分别记录全部患者的关节肿胀数、关节压痛数、晨僵时间和红细胞沉降率的变化,通过治疗前及治疗后24个月分别记录手足X线正位片、Sharp评分和DAS28评分标准进行评价。结果：治疗12个月后病例组临床指标的改善较对照组差（P〈0.01）;24个月后病例组X线分期变化情况进展明显大于对照组（P〈0.01）。结论：抗角蛋白抗体阳性谱患者的临床指标和影像学变化情况较抗角蛋白抗体谱阴性患者对治疗的反应较差,更易发生关节破坏。

The Predictive Value of Serum Antikeratin Antibody Spectrum on Bone Erosion in Patients with Rheumatoid Arthritis

Objective： To study the predictive value of serum antikeratin antibody spectrum on bone erosion in patients with rheumatoid arthritis. Methods： 82 patients with active early RA were recruited and divided into two groups： the study group（anti-CCP or AKA positivity, n=39） and control group （anti-CCP and AKA negative, n=43）. Disease activity measures including swollen, tender joint count, time and erythrocyte sedimentation rate （ESR） were documented at baseline, the 12th month and the 24th months. Radiological joint damage and DAS28 score were assessed before and after 24 months of follow up. Results： Disease activity of anti-CCP or AKA positivity RA patients was controlled poorly compared with anti-CCP and AKA negative RA patients after 12 months and 24 months （ P 〈0.01）. Clinically indicated progressive radiographic damage was increased significantly in the patients with anti-CCP and AKA positivity RA. Conclusion： The patients with positive Anti-keratin antibody spectrum exhibits more radiological joint damage and poor progression than the patients with negative Anti-keratin antibody spectrum.