Voskuyl A E, Emeis J J, Hazes J M, van Hogezand R A, Biemond I, Breedveld F C
Department of Rheumatology, Leiden University Medical Center, The Netherlands.
Clin Exp Rheumatol. 1998 Jul-Aug;16(4):429-34.
To investigate whether serum levels of circulating cellular fibronectin (cFN) are increased in patients with rheumatoid arthritis (RA) complicated by vasculitis.
Levels of serum cFN were determined by an enzyme-linked immunosorbent assay (ELISA) in 26 RA patients with histologically proven vasculitis of recent onset (RV) and were compared to the levels in 47 RA patients with extraarticular manifestations of recent onset but no histological evidence of vasculitis (RA+), 43 patients with uncomplicated RA (RA-), 16 patients with systemic lupus erythematosus and active disease (SLE), 30 patients with active Crohn's disease (CD), 21 young healthy controls (yHC) and 17 elderly healthy controls (eHC). Plasma levels of cFN and von Willebrand factor antigen were also determined in the RA patients.
In RV patients, the median cFN level was significantly (P = 0.01) higher compared to that of RA+ patients, and was also significantly (P < 0.0000) higher compared to the cFN level in the RA-, SLE, CD, yHC and eHC groups. When compared to eHC, the cFN level was significantly higher in RA+ (P = 0.008); it was also higher in RA-, although not significantly (P = 0.42). 77% of the RV patients, 55% of the RA+ patients, and 37% of the RA-patients had a cFN level > 2 SD above the mean level for eHC. At an optimal cut-off titre the sensitivity of the cFN ELISA in discriminating RV patients from RA+ patients was 90%, the specificity was 46% and the accuracy was 68%. Plasma levels of cFN correlated significantly (r = 0.62; P < 0.001) with the von Willebrand factor antigen levels.
Increased levels of serum cFN are present in patients with RA, and are frequently found in RA patients with extraarticular manifestations, particularly in those with vasculitis.
研究类风湿关节炎（RA）合并血管炎患者血清中循环细胞纤连蛋白（cFN）水平是否升高。
采用酶联免疫吸附测定（ELISA）法测定26例近期发病且经组织学证实有血管炎的RA患者（RV）的血清cFN水平，并与47例近期有关节外表现但无血管炎组织学证据的RA患者（RA+）、43例无并发症的RA患者（RA-）、16例患有活动性疾病的系统性红斑狼疮患者（SLE）、30例活动性克罗恩病患者（CD）、21例年轻健康对照者（yHC）和17例老年健康对照者（eHC）的cFN水平进行比较。还测定了RA患者血浆中的cFN和血管性血友病因子抗原水平。
与RA+患者相比，RV患者的cFN水平中位数显著升高（P = 0.01），与RA-、SLE、CD、yHC和eHC组的cFN水平相比也显著升高（P < 0.0000）。与eHC相比，RA+患者的cFN水平显著升高（P = 0.008）；RA-患者的cFN水平也较高，尽管差异不显著（P = 0.42）。77%的RV患者、55%的RA+患者和37%的RA-患者的cFN水平高于eHC平均水平2个标准差以上。在最佳临界值时，cFN ELISA鉴别RV患者与RA+患者的敏感性为90%，特异性为4⃣️6%，准确性为68%。血浆cFN水平与血管性血友病因子抗原水平显著相关（r = 0.62；P < 0.001）。
RA患者血清cFN水平升高，且在有关节外表现的RA患者中常见，尤其是合并血管炎的患者。
