Sihvonen Susanna, Korpela Markku, Mustila Anu, Mustonen Jukka
Department of Internal Medicine and Centre for Laboratory Medicine, Tampere University Hospital, University of Tampere Medical School, Tampere, Finland.
J Rheumatol. 2005 Nov;32(11):2089-94.
To evaluate the significance of rheumatoid factor (RF) and its isotypes (IgA RF, IgG RF, and IgM RF), anti-cyclic citrullinated peptide antibodies (anti-CCP), and antineutrophil cytoplasmic antibodies (ANCA) in predicting mortality in patients with rheumatoid arthritis (RA).
The study population comprised 604 patients with RA participating in a cross-sectional study in 1987. Presence of RF (n = 604), RF isotypes (n = 206), anti-CCP (n = 184), and ANCA (n = 200) were determined in these patients from available baseline sera. Vital status was assessed in 1999 and multivariate Cox regression analysis used to compare mortality in RA patients with or without different antibodies.
Of the 604 patients with RA, 55% were positive for RF, 66% for anti-CCP, and 14.5% for perinuclear ANCA. Twelve patients (19%) with RF were anti-CCP-negative and 34 (40%) without RF were anti-CCP-positive. Of the total 604 patients, 160 had died by 1999. Positive RF and high IgA and IgM RF levels predicted increased mortality, while positive anti-CCP or ANCA did not. However, high anti-CCP levels were related to an increased mortality risk.
Patients with RA with positive RF, especially IgA and IgM isotypes, carry a risk of dying earlier than patients without these serological findings.
评估类风湿因子（RF）及其亚型（IgA RF、IgG RF和IgM RF）、抗环瓜氨酸肽抗体（抗CCP）和抗中性粒细胞胞浆抗体（ANCA）在预测类风湿关节炎（RA）患者死亡率中的意义。
研究人群包括1987年参与一项横断面研究的604例RA患者。从可用的基线血清中检测这些患者的RF（n = 604）、RF亚型（n = 206）、抗CCP（n = 184）和ANCA（n = 200）的存在情况。1999年评估生存状态，并使用多变量Cox回归分析比较有或没有不同抗体的RA患者的死亡率。
在604例RA患者中，55%的患者RF呈阳性，66%的患者抗CCP呈阳性，14.5%的患者核周型ANCA呈阳性。12例（19%）RF阳性患者抗CCP阴性，34例（40%）RF阴性患者抗CCP阳性。在总共604例患者中，到1999年有160例死亡。RF阳性以及高IgA和IgM RF水平预示死亡率增加，而抗CCP或ANCA阳性则不然。然而，高抗CCP水平与死亡风险增加有关。
RF阳性的RA患者，尤其是IgA和IgM亚型患者，比没有这些血清学表现的患者有更早死亡的风险。
