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类风湿性关节炎患者血清和滑液中的免疫学发现(作者译)

[Immunological findings in serum and synovial fluid in patients with rheumatoid arthritis (author's transl)].

作者信息

Stojan B, Hasler F

出版信息

Wien Klin Wochenschr. 1977 Nov 11;89(21):713-6.

PMID:919557
Abstract

Sera and synovial fluid were investigated in 45 patients with rheumatoid Arthritis and 50 patients with osteoarthritis in inflammatory exacerbation (control group). The following tests were performed: IgG, IgM, IgA determinations, complement components C3, C3, C4, C3-proactivator, ceruloplasmin, electrophoresis, LDH and total acid phosphatase. 1. Serum levels of the ceruloplasmin, alpha 1, alpha 2 and gamma fractions of electrophoresis are significantly higher in patients with rheumatoid arthritis than in patients with osteoarthritis. 2. Synovial fluid: a) There is a significantly higher concentration of IgG, IgM, IgA, C3-proactivator and total acid phosphatase in the synovial fluid of patients with rheumatoid arthritis. b) C4 is significantly lower in patients with rheumatoid arthritis. c) Both groups were also compared with the help of a point system. Every patient received a plus point when the following criteria were seen: IgM greater than 150 mg/100 ml, C3 greater than 50 mg/100 ml, ceruloplasmin greater than 35 mg/100 ml, alpha 1 greater than 0.21 g%, alpha 2 greater than 0.44 g%, beta greater than 0.60 g% and gamma fraction on electrophoresis greater than 0.90 g%. Another point was added if the criteria ceruloplasmin greater than 22 mg/100 ml and C4 less than 17 mg/100 ml were simultaneously seen. With the help of this points system 48 out of the 50 osteoarthritis patients (96%) received zero points, one received 1 point and one 2 points, as opposed to the patients with rheumatoid arthritis where 35 out of 45 (78%) received one or more points. d) The differentation is not improved through additional testing of the rheumatic factors.

摘要

对45例类风湿性关节炎患者和50例处于炎症加重期的骨关节炎患者(对照组)的血清和滑液进行了研究。进行了以下检测:IgG、IgM、IgA测定,补体成分C3、C3、C4、C3 - 前活化剂、铜蓝蛋白、电泳、乳酸脱氢酶和总酸性磷酸酶。1. 类风湿性关节炎患者血清中的铜蓝蛋白、电泳的α1、α2和γ组分水平显著高于骨关节炎患者。2. 滑液:a)类风湿性关节炎患者滑液中IgG、IgM、IgA、C3 - 前活化剂和总酸性磷酸酶的浓度显著更高。b)类风湿性关节炎患者的C4显著更低。c)两组还通过评分系统进行了比较。当出现以下标准时,每位患者得一分:IgM大于150mg/100ml、C3大于50mg/100ml、铜蓝蛋白大于35mg/100ml、α1大于0.21g%、α2大于0.44g%、β大于0.60g%且电泳的γ组分大于0.90g%。如果同时出现铜蓝蛋白大于22mg/100ml和C4小于17mg/100ml的标准,则再加一分。借助该评分系统,50例骨关节炎患者中有48例(96%)得零分,1例得1分,1例得2分,而类风湿性关节炎患者中45例中有35例(78%)得一分或更多分。d)通过额外检测风湿因子,鉴别并未得到改善。

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