抗环瓜氨酸肽抗体在类风湿性关节炎继发间质性肺疾病中的作用及关系*

Role and correlation analysis of anti-cyclic citrullinated peptide antibody in the pathogenesis of rheumatoid arthritis related interstitial lung disease*

摘要:

目的 观察抗环瓜氨酸肽抗体（抗CCP抗体）在类风湿性关节炎（RA）继发间质性肺疾病（ILD）患者中的阳性检出率及其与ILD临床、影像和疾病相关实验室指标等的关系，探讨抗CCP抗体在RA-ILD发病中的作用。方法 选取2017年1月—2018年9月于内蒙古科技大学包头医学院第一附属医院就诊的RA患者98例。统计临床及辅助检查资料（包括肺部影像检查、肺功能、血气及其他RA相关实验室指标）。依据RA患者是否合并ILD，分为RA-ILD组（50例）和RA无ILD组（48例），分析两组患者血清抗CCP抗体阳性表达的差异，以及RA-ILD组抗CCP抗体与RA-ILD相关指标的相关性。结果 抗CCP抗体在RA-ILD组中的阳性率为76.0%，高于RA无ILD组阳性率（P?<0.05）；RA-ILD组的患者比RA无ILD组患者的关节肿胀数更多（P?<0.05），但两组患者的关节疼痛数、晨僵持续时间比较，差异无统计学意义（P?>0.05）；ESR、RF、CRP、DAS28及临床、影像、生理评分和CRP评分、肺功能（FVC%pred及DLCO%pred）、血气 PaO2对预测抗CCP抗体滴度无意义（P?>0.05）。结论 抗CCP抗体对RA-ILD发病具有一定预测价值。

Abstract:

Objective To observe the positive rate of anti-cyclic citrullinated peptides antibody (anti-CCP antibody) in patients with rheumatoid arthritis (RA) associated interstitial lung disease (RA-ILD) and its correlation with indicators of ILD clinical, imaging and laboratory in order to explore the role of anti-CCP antibodies in the pathogenesis of RA-ILD. Method The clinical data and auxiliary examination (including lung imaging, lung function, blood gas and other RA related laboratory indicators) of 98 RA patients in our hospital from January 2017 to September 2018 were retrospectively collected. According to whether the patient with ILD, they were divided into RA-ILD group (50 cases) and RA without ILD group (48 cases). The differences of serum anti-CCP antibody expression between two groups and the correlation between the anti-CCP antibody and the ILD related score in the RA-ILD group were analyzed. Results The positive rate of anti-CCP antibody in RA-ILD was 76.0%, which is higher than it in RA without ILD (P??0.05); there was no significant correlation between anti-CCP antibody level and DSA28 score in RA-ILD patients (P?>?0.05); there was no significant correlation between the anti-CCP antibody titer and the Clinical-Radiographic-Physiologic (CRP) score, lung function and oxygen partial pressure associated with ILD in patients with RA-ILD (P?>?0.05). Conclusion Anti-CCP antibody is involved in the pathogenesis of RA-ILD and is expected to be a predictor of RA-ILD.