抗BRAF抗体在RA患者血清中表达水平及其临床意义探讨

发布时间：2018-04-29 13:09

本文选题：关节炎 + 类风湿　；参考：《宁夏医科大学》2015年硕士论文

【摘要】：目的:探讨抗鼠科肉瘤病毒癌基因同源物B1(v-raf murine sarcomaviral oncogene homologue B1,BRAF)抗体在类风湿关节炎(rheumatoid arthritis,RA)患者血清中表达水平及其临床意义。方法:采用酶联免疫吸附法(enzyme-linked immunosorbent assays,ELISA)检测RA 95例、其他风湿性疾病88例和健康对照组48例血清中抗BRAF抗体水平。收集各组的病例资料,探讨血清中自身抗体水平与RA临床症状、实验室检查结果及相关影像学变化之间的关系。结果:①抗BRAF抗体在RA组患者血清中的表达水平明显高于其他风湿性疾病组(Z=-5.213,P0.01),明显高于健康对照组(Z=-4.335,P0.01)。②抗BRAF抗体的ROC曲线下面积为(AUC)=0.723±0.039(95%CI:0.646-0.800),其诊断RA的最佳界点为抗BRAF抗体OD0.4,灵敏度为58.947%,特异度为92.6%。③抗BRAF抗体在RA患者血清中的阳性率58.95%,明显高于强直性脊柱炎组及系统性红斑狼疮组(12.5%,P0.01;15%,P0.01),明显高于健康对照组(8.33%,P0.01)。④RA组中类风湿因子(rheumatoid factor,RF)阴性患者血清中抗BRAF抗体阳性率明显高于RF阳性患者(χ2=7.891,P0.01)。⑤RA组关节肿胀患者血清抗BRAF抗体阳性率明显高于无关节肿胀患者(χ2=5.508,P0.05)。RA组患者抗BRAF抗体表达水平与病程(r=-0.334,P0.05)、血红蛋白(hemoglobin,HGB)(r=-0.212,P0.05)呈负相关。⑥RA组抗BRAF抗体水平与骨质破坏:双手X线正位片显示正常组与骨质破坏组抗BRAF抗体阳性率差异无统计学意义(χ2=1.091,P0.05)。⑦RA组抗BRAF抗体水平与肺间质纤维化:胸部CT显示正常组与肺间质纤维化组抗BRAF抗体阳性率差异无统计学意义(χ2=0.062,P0.05)。结论①抗BRAF抗体在RA患者中高表达,可作为新的自身抗体应用于RA的诊断。②抗BRAF抗体在早期RA患者及RF阴性的RA患者中具有较高的阳性率。③抗BRAF抗体与RA患者的病情活动性呈正相关。④抗BRAF抗体与关节骨质破坏、肺部累及无明显相关性。
[Abstract]:Objective: to investigate the expression and clinical significance of anti-mouse sarcomas virus oncogene congener B1(v-raf murine sarcomaviral oncogene homologue B1-BRAF in serum of patients with rheumatoid arthritis (RA). Methods: Elisa was used to detect the levels of anti BRAF antibody in serum of 95 patients with RA, 88 patients with other rheumatic diseases and 48 healthy controls. To investigate the relationship between serum autoantibody level and clinical symptoms, laboratory findings and imaging changes of RA. Results the expression of BRAF antibody against BRAF in RA group was significantly higher than that in other rheumatic diseases group (P 0.01), and the area under the ROC curve of anti BRAF antibody was 0.723 卤0.039 95 CI: 0. 646-0. 800 in RA group. The best diagnostic threshold for RA was anti BRAF. The positive rate of antibody OD0.4, sensitivity 58.947 and specificity 92.6.3 in serum of RA patients was 58.95, which was significantly higher than that in ankylosing spondylitis group and systemic lupus erythematosus group, and significantly higher than that in healthy control group (8.33P0.01n.4RA). The positive rate of anti BRAF antibody in serum of patients with negative rheumatoid factorization was significantly higher than that of patients with RF positive (蠂 27.891% P 0.01U .5RA) compared with those without joint swelling (蠂 2 5.508% P 0.05 0. 05%). The expression of anti BRAF antibody and the course of disease in RA group were significantly higher than those in non joint swelling group (蠂 2 5. 508% P 0. 05%, P 0. 05%, P 0. 05%). There was a negative correlation between anti BRAF antibody level and bone destruction in 6RA group. There was no significant difference in anti BRAF antibody positive rate between normal group and bone destruction group (蠂 2. 091 P 0. 05 P 0. 05 RA group). Pulmonary interstitial fibrosis: there was no significant difference in the positive rate of anti BRAF antibody between normal group and pulmonary interstitial fibrosis group (蠂 2 0. 062 P 0 05). Conclusion 1 the anti BRAF antibody is highly expressed in RA patients. The anti BRAF antibody can be used as a new autoantibody in the diagnosis of RA. 2. There is a high positive rate of anti BRAF antibody in early RA patients and RF negative RA patients. 3. 3 anti BRAF antibody is positively correlated with the disease activity of RA patients. 4 anti BRAF antibody is positively correlated with the disease activity of RA patients. Body and joint bone destruction, There was no significant correlation between lung involvement and lung involvement.
【学位授予单位】：宁夏医科大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R593.22

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