北京大学学报(医学版) ›› 2020, Vol. 52 ›› Issue (6): 1023-1028. doi: 10.19723/j.issn.1671-167X.2020.06.006
Jing-feng ZHANG,Xiu-ling YE,Meng DUAN,Xiao-li ZHOU,Zhong-qiang YAO,Jin-xia ZHAO()
摘要:
目的:分析抗核抗体(anti-nuclear antibodies, ANA)阳性类风湿关节炎(rheumatoid arthritis,RA)患者的临床及实验室检查特征。方法:选择2013年1月—2018年12月于北京大学第三医院风湿免疫科住院的428例RA患者的临床及实验室检查资料,回顾性分析ANA阳性RA患者的临床和实验室检查指标的特点。统计学方法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χ2检验,1≤理论频数<5采用校正四格表χ2检验,理论频数<1采用确切概率法。结果:收集到ANA阳性患者共231例(54%),ANA阳性组中女性占比明显多于ANA阴性组(82.7% vs. 63.5%, χ2=20.355,P<0.01);ANA阳性组出现跖趾关节受累(22.1%)低于ANA阴性组(33.0%, χ2=6.414,P<0.05),ANA阳性组中合并继发性干燥综合征(secondary Sj?gren’s syndrome, sSS)的比例显著高于ANA阴性组(19.5% vs. 4.1%, χ2=23.300,P<0.01);ANA阳性组合并类风湿因子(rheumatoid factor, RF)阳性(77.1% vs. 53.8%, χ2=25.743,P<0.01)及抗环瓜氨酸多肽(cyclic citrullinated peptide,CCP)抗体阳性(74.9% vs. 59.4%, χ2=11.694,P<0.01)的比例均显著高于阴性组。ANA阳性组免疫球蛋白G(immunoglobulin G,IgG)水平[(15.1±5.1) g/L vs. (13.8±5.3) g/L, t=2.359, P<0.05]及免疫球蛋白M(immunoglobulin M,IgM)水平[1.25(0.92) g/L vs.1.05(0.65) g/L, Z=-3.449, P<0.01]高于阴性组,而血红蛋白(hemoglobin, Hb)水平[(109.64±17.98) vs. (114.47±18.48) g/L,t=-2.734, P<0.01]、血小板(platelet, PLT)水平[(266.4×109±104.6×109) vs. (295.9×109±100.1×109) /L,t=-2.970, P<0.01]低于阴性组。结论:ANA阳性RA患者合并sSS的比例显著高于ANA阴性者,前者IgG水平更高,而Hb及PLT水平则更低。
中图分类号:
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