Saraux A, Valls I, Voisin V, Koreichi A, Baron D, Youinou P, Le Goff P
Service de Rhumatologie, C.H.U. Morvan, Brest, France.
Rev Rhum Engl Ed. 1995 Jan;62(1):16-20.
To evaluate the usefulness for the diagnosis of rheumatoid arthritis of tests for rheumatoid factors, antiperinuclear factors, antikeratin antibodies, and the HLA DR4 antigen, we retrospectively reviewed the medical records of 138 patients consecutively admitted to our rheumatology department between January 1, 1988 and December 31, 1990 for evaluation of peripheral inflammatory joint manifestations. Each patient had a standard work-up including a physical examination, laboratory tests, and roentgenograms. In 1994, after a follow-up of three to six years, the final diagnosis was rheumatoid arthritis in 39 patients and another well-defined disorder in 63; no diagnosis was established in 36 patients, among whom nine were lost to follow-up. The decreasing order of diagnostic usefulness was antiperinuclear factors, HLA DR4, rheumatoid factors (latex test), and antikeratin antibody. The likelihood of rheumatoid arthritis was greatest in those patients with positivity of two of the three following markers: rheumatoid factors, antiperinuclear factors, and the HLA DR4 antigen.
为评估类风湿因子、抗核周因子、抗角蛋白抗体及HLA DR4抗原检测对类风湿关节炎诊断的价值，我们回顾性分析了1988年1月1日至1990年12月31日期间连续入住我院风湿科的138例因外周炎性关节表现入院患者的病历。每位患者均接受了包括体格检查、实验室检查及X线检查在内的标准检查。1994年，在随访3至6年后，最终诊断为类风湿关节炎的患者有39例，明确诊断为其他疾病的患者有63例；36例患者未明确诊断，其中9例失访。诊断价值由高到低依次为抗核周因子、HLA DR4、类风湿因子（乳胶试验）及抗角蛋白抗体。类风湿因子、抗核周因子及HLA DR4抗原这三项指标中两项呈阳性的患者患类风湿关节炎的可能性最大。
