抗核抗体阳性的类风湿关节炎的临床及实验室特征
[Clinical and laboratory characteristics of rheumatoid arthritis with positive antinuclear antibody].
作者信息
Zhang J F, Ye X L, Duan M, Zhou X L, Yao Z Q, Zhao J X
出版信息
Beijing Da Xue Xue Bao Yi Xue Ban. 2020 Dec 18;52(6):1023-1028. doi: 10.19723/j.issn.1671-167X.2020.06.006.
OBJECTIVE
To analyse the clinical and laboratory characteristics of antinuclear antibody (ANA) positive rheumatoid arthritis (RA) patients.
METHODS
The clinical and laboratory data of 428 RA cases from Department of of Rheumatology and Immunology Peking University Third Hospital from Jan 2013 to Dec 2018 were collected and used to analyse characters between ANA positive group and ANA negative group. T test was used for the quantitative data in accordance with normal distribution. Wilcoxon rank sum test was used for the quantitative data of non normal distribution. The qualitative data were analyzed by chi square test. But while 1≤theoretical frequency < 5, chi square test of corrected four grid table was used. And Fisher exact probability method was used when theoretical frequency < 1.
RESULTS
The number of ANA positive group was 231 (54%). The female rate was obviously higher in ANA positive group (82.7% . 63.5%, =20.355, < 0.01). The rate of metatarsophalangeal joints (MTPJs) involvement was lower in ANA positive group (22.1%) than in ANA negative group (33.0) (=6.414, < 0.05). The incidence of secondary Sjögren's syndrome (sSS) was much higher in ANA positive group(19.5% . 4.1%, =23.300, < 0.01). The positivity of rheumatoid factor (RF), as well as the positivity of anti-cyclic citrullinated peptide(CCP) antibody was much higher in ANA positive group (77.1% . 53.8%, =25.743, < 0.01, 74.9% . 59.4%, =11.694, < 0.01, respectively). The levels of immunoglobulin G (IgG) and immunoglobulin M (IgM) of ANA positive group were higher [(15.1±5.1) g/L . (13.8±5.3) g/L, =2.359, < 0.05, 1.25 (0.92) g/L . 1.05 (0.65) g/L, Z=-3.449, < 0.01, respectively]. But the levels of hemoglobin (Hb) and platelet (PLT) was lower in ANA positive group[(109.64±17.98) . (114.47±18.48) g/L, =-2.734, < 0.01; (266.4×10±104.6×10) . (295.9×10±100.1×10) /L, =-2.970, < 0.01, respectively].
CONCLUSION
The incidence of sSS was obviously higher in ANA positive group than in ANA negative group. Serum IgG of ANA positive group was higher, but Hb and PLT were lower.
目的
分析抗核抗体（ANA）阳性类风湿关节炎（RA）患者的临床及实验室特征。
方法
收集2013年1月至2018年12月北京大学第三医院风湿免疫科428例RA患者的临床及实验室资料，分析ANA阳性组与ANA阴性组的特征。符合正态分布的定量资料采用t检验，非正态分布的定量资料采用Wilcoxon秩和检验，定性资料采用卡方检验。但当1≤理论频数＜5时，采用校正四格表卡方检验；当理论频数＜1时，采用Fisher确切概率法。
结果
ANA阳性组231例（54%）。ANA阳性组女性比例明显更高（82.7%对63.5%，χ² = 20.355，P＜0.01）。ANA阳性组跖趾关节（MTPJs）受累率低于ANA阴性组（22.1%对33.0%，χ² = 6.414，P＜0.05）。ANA阳性组继发性干燥综合征（sSS）发病率明显更高（19.5%对4.1%，χ² = 23.300，P＜0.01）。ANA阳性组类风湿因子（RF）阳性率以及抗环瓜氨酸肽（CCP）抗体阳性率均明显更高（分别为77.1%对53.8%，χ² = 25.743，P＜0.01；74.9%对59.4%，χ² = 11.694，P＜0.01）。ANA阳性组免疫球蛋白G（IgG）和免疫球蛋白M（IgM）水平更高[（15.1±5.1）g/L对（13.8±5.3）g/L，t = 2.359，P＜0.05；1.25（0.92）g/L对1.05（0.65）g/L，Z = -3.449，P＜0.01]。但ANA阳性组血红蛋白（Hb）和血小板（PLT）水平更低[（109.64±17.98）对（114.47±18.48）g/L，t = -2.734，P＜0.01；（266.4×10⁹±104.6×10⁹）对（295.9×10⁹±100.1×10⁹）/L，t = -2.970，P＜0.01]。
结论
ANA阳性组sSS发病率明显高于ANA阴性组。ANA阳性组血清IgG更高，但Hb和PLT更低。
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