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  本文選題：關節(jié)炎 + 類風濕　； 參考：《寧夏醫(yī)科大學》2015年碩士論文

【摘要】：目的:探討抗鼠科肉瘤病毒癌基因同源物B1(v-raf murine sarcomaviral oncogene homologue B1,BRAF)抗體在類風濕關節(jié)炎(rheumatoid arthritis,RA)患者血清中表達水平及其臨床意義。方法:采用酶聯免疫吸附法(enzyme-linked immunosorbent assays,ELISA)檢測RA 95例、其他風濕性疾病88例和健康對照組48例血清中抗BRAF抗體水平。收集各組的病例資料,探討血清中自身抗體水平與RA臨床癥狀、實驗室檢查結果及相關影像學變化之間的關系。結果:①抗BRAF抗體在RA組患者血清中的表達水平明顯高于其他風濕性疾病組(Z=-5.213,P0.01),明顯高于健康對照組(Z=-4.335,P0.01)。②抗BRAF抗體的ROC曲線下面積為(AUC)=0.723±0.039(95%CI:0.646-0.800),其診斷RA的最佳界點為抗BRAF抗體OD0.4,靈敏度為58.947%,特異度為92.6%。③抗BRAF抗體在RA患者血清中的陽性率58.95%,明顯高于強直性脊柱炎組及系統(tǒng)性紅斑狼瘡組(12.5%,P0.01;15%,P0.01),明顯高于健康對照組(8.33%,P0.01)。④RA組中類風濕因子(rheumatoid factor,RF)陰性患者血清中抗BRAF抗體陽性率明顯高于RF陽性患者(χ2=7.891,P0.01)。⑤RA組關節(jié)腫脹患者血清抗BRAF抗體陽性率明顯高于無關節(jié)腫脹患者(χ2=5.508,P0.05)。RA組患者抗BRAF抗體表達水平與病程(r=-0.334,P0.05)、血紅蛋白(hemoglobin,HGB)(r=-0.212,P0.05)呈負相關。⑥RA組抗BRAF抗體水平與骨質破壞:雙手X線正位片顯示正常組與骨質破壞組抗BRAF抗體陽性率差異無統(tǒng)計學意義(χ2=1.091,P0.05)。⑦RA組抗BRAF抗體水平與肺間質纖維化:胸部CT顯示正常組與肺間質纖維化組抗BRAF抗體陽性率差異無統(tǒng)計學意義(χ2=0.062,P0.05)。結論①抗BRAF抗體在RA患者中高表達,可作為新的自身抗體應用于RA的診斷。②抗BRAF抗體在早期RA患者及RF陰性的RA患者中具有較高的陽性率。③抗BRAF抗體與RA患者的病情活動性呈正相關。④抗BRAF抗體與關節(jié)骨質破壞、肺部累及無明顯相關性。
[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 鹵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.
【學位授予單位】：寧夏醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2015
【分類號】：R593.22

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