抗MCV抗体、抗CCP抗体对类风湿关节炎疾病活动及骨侵蚀破坏的预测价值及其与患者心理健康关系的研究

发布时间：2018-06-11 13:11

  本文选题：抗MCV抗体 + 抗CCP抗体　； 参考：《山西医科大学》2017年硕士论文

【摘要】：目的:探讨抗突变型瓜氨酸蛋白(mutated citrullinated vimentin,MCV)抗体、抗环瓜氨酸肽(cyclic citrullinated peptide,CCP)抗体与类风湿关节炎(Rheumatoid arthritis,RA)疾病活动度及骨侵蚀破坏之间的关系,并比较上述两种抗体对疾病严重程度的预测价值;探讨抗MCV抗体、抗CCP抗体与RA患者特质应对与抑郁评分的关系,评估患者心理健康状态,为患者提供个体化的诊疗方案提供依据。方法:1.收集2014年12月至2016年1月解放军264医院、山西医科大学第二医院的住院RA患者634例,记录患者同期临床及实验室资料。依据DAS28评分评估患者疾病活动程度;根据美国风湿病学会(ACR)提出的X线分期标准评估RA患者骨侵蚀组破坏程度。2.收集2016年1月至2017年2月解放军264医院符合纳入标准的门诊及住院RA患者118例,记录患者同期临床及实验室资料,并通过采用健康评定问卷(HAQ)评估患者的生活质量,采用特质应对量表(TCSQ)及流调用抑郁自评量表(CSE-D)评估RA患者心理健康状况。结果:第一部分:抗MCV抗体及抗CCP抗体与RA骨侵蚀及疾病活动相关性的研究1.RA患者抗MCV抗体与ESR、CRP、关节压痛数、DAS28评分呈正相关(P0.05),抗CCP抗体与上述指标均未见相关;2.抗MCV抗体在疾病高度活动及中度活动患者中均高于低度活动及疾病稳定患者(P0.05);抗CCP抗体在疾病中度活动患者中高于低度活动及疾病稳定患者(P0.05)。3.抗MCV抗体、抗CCP抗体在骨侵蚀患者中高于非骨侵蚀患者(P0.05);抗MCV抗体在受累关节骨侵蚀破坏II期、Ⅲ期患者明显高于Ⅰ期患者(P0.05),抗CCP抗体则在骨侵蚀破坏II期、Ⅲ期较Ⅰ期升高(P0.05),Ⅲ期较Ⅳ期升高(P0.05)。第二部分:抗MCV抗体及抗CCP抗体与RA患者特质应对、抑郁评分及生活质量关系的研究1.抗体MCV抗体、抗CCP抗体滴度与RA患者特质应对、抑郁评分及健康评定问卷积分、年龄、患病时间均无相关性(P0.05),特质应对中积极应对评分与病情活动度呈负相关(P0.05);2.抗MCV、抗CCP抗体阳阴性组间RA患者特质应对、抑郁评分及HAQ积分、年龄、患病时间差异均无统计学意义(P0.05);3.轻度抑郁倾向患者DAS28评分明显高于无抑郁倾向患者(P0.05),无抑郁倾向及轻度抑郁倾向患者较明显抑郁倾向患者更偏向于积极应对(P0.05),轻度抑郁倾向及明显抑郁倾向患者较无抑郁倾向组患者更偏向消极应对(P0.05)。结论:1.抗MCV抗体较抗CCP抗体能更好地评估病情活动,对骨侵蚀具有更好的预测价值。2.RA患者血清中抗MCV抗体及抗CCP抗体与患者心理健康状态、年龄、患病时间无关,病情较重、抑郁倾向明显的患者在日常生活中更倾向于消极应对。
[Abstract]:Objective: to investigate the relationship between anti-mutated citrullinated vimentin (MCV) antibody, anti-cyclic citrullinated peptide (citrullinated) antibody and disease activity and bone erosion in rheumatoid arthritis (RA). The relationship between anti-MCV antibody, anti-CCP antibody and trait coping and depression score of RA patients was discussed, and the mental health status of RA patients was evaluated. To provide patients with individualized diagnosis and treatment program to provide the basis. Method 1: 1. From December 2014 to January 2016, 634 RA patients from 264 Hospital of PLA and the second Hospital of Shanxi Medical University were collected, and the clinical and laboratory data were recorded. The degree of disease activity was evaluated according to DAS28 score, and the degree of bone erosion was assessed according to the X-ray staging standard proposed by the American Society of Rheumatology (ACR). From January 2016 to February 2017, 118 patients with RA who met the inclusion criteria were collected in 264 Hospital of PLA. Clinical and laboratory data of the patients were recorded, and the quality of life of the patients was assessed by health assessment questionnaire (HAQ). The mental health status of RA patients was evaluated by trait coping scale (TCSQ) and flow call Depression scale (CSE). Results: the first part: correlation between anti-MCV antibody and anti-CCP antibody and RA bone erosion and disease activity. 1. Anti-MCV antibody was positively correlated with ESRV CRP, joint tenderness number and DAS28 score, but anti-CCP antibody was not correlated with the above indexes. Anti-MCV antibody in patients with high activity and moderate activity was higher than that in patients with low activity and stable disease (P0.05), and anti-CCP antibody in patients with moderate activity was higher than that in patients with low activity and stable disease. Anti-MCV antibody and anti-CCP antibody were higher in bone erosion patients than in non-bone erosion patients (P 0.05). Compared with stage 鈪，

本文编号：2005363