本文選題：抗MCV抗體 + 抗CCP抗體��； 參考：《山西醫(yī)科大學》2017年碩士論文

【摘要】：目的:探討抗突變型瓜氨酸蛋白(mutated citrullinated vimentin,MCV)抗體、抗環(huán)瓜氨酸肽(cyclic citrullinated peptide,CCP)抗體與類風濕關(guān)節(jié)炎(Rheumatoid arthritis,RA)疾病活動度及骨侵蝕破壞之間的關(guān)系,并比較上述兩種抗體對疾病嚴重程度的預(yù)測價值;探討抗MCV抗體、抗CCP抗體與RA患者特質(zhì)應(yīng)對與抑郁評分的關(guān)系,評估患者心理健康狀態(tài),為患者提供個體化的診療方案提供依據(jù)。方法:1.收集2014年12月至2016年1月解放軍264醫(yī)院、山西醫(yī)科大學第二醫(yī)院的住院RA患者634例,記錄患者同期臨床及實驗室資料。依據(jù)DAS28評分評估患者疾病活動程度;根據(jù)美國風濕病學會(ACR)提出的X線分期標準評估RA患者骨侵蝕組破壞程度。2.收集2016年1月至2017年2月解放軍264醫(yī)院符合納入標準的門診及住院RA患者118例,記錄患者同期臨床及實驗室資料,并通過采用健康評定問卷(HAQ)評估患者的生活質(zhì)量,采用特質(zhì)應(yīng)對量表(TCSQ)及流調(diào)用抑郁自評量表(CSE-D)評估RA患者心理健康狀況。結(jié)果:第一部分:抗MCV抗體及抗CCP抗體與RA骨侵蝕及疾病活動相關(guān)性的研究1.RA患者抗MCV抗體與ESR、CRP、關(guān)節(jié)壓痛數(shù)、DAS28評分呈正相關(guān)(P0.05),抗CCP抗體與上述指標均未見相關(guān);2.抗MCV抗體在疾病高度活動及中度活動患者中均高于低度活動及疾病穩(wěn)定患者(P0.05);抗CCP抗體在疾病中度活動患者中高于低度活動及疾病穩(wěn)定患者(P0.05)。3.抗MCV抗體、抗CCP抗體在骨侵蝕患者中高于非骨侵蝕患者(P0.05);抗MCV抗體在受累關(guān)節(jié)骨侵蝕破壞II期、Ⅲ期患者明顯高于Ⅰ期患者(P0.05),抗CCP抗體則在骨侵蝕破壞II期、Ⅲ期較Ⅰ期升高(P0.05),Ⅲ期較Ⅳ期升高(P0.05)。第二部分:抗MCV抗體及抗CCP抗體與RA患者特質(zhì)應(yīng)對、抑郁評分及生活質(zhì)量關(guān)系的研究1.抗體MCV抗體、抗CCP抗體滴度與RA患者特質(zhì)應(yīng)對、抑郁評分及健康評定問卷積分、年齡、患病時間均無相關(guān)性(P0.05),特質(zhì)應(yīng)對中積極應(yīng)對評分與病情活動度呈負相關(guān)(P0.05);2.抗MCV、抗CCP抗體陽陰性組間RA患者特質(zhì)應(yīng)對、抑郁評分及HAQ積分、年齡、患病時間差異均無統(tǒng)計學意義(P0.05);3.輕度抑郁傾向患者DAS28評分明顯高于無抑郁傾向患者(P0.05),無抑郁傾向及輕度抑郁傾向患者較明顯抑郁傾向患者更偏向于積極應(yīng)對(P0.05),輕度抑郁傾向及明顯抑郁傾向患者較無抑郁傾向組患者更偏向消極應(yīng)對(P0.05)。結(jié)論:1.抗MCV抗體較抗CCP抗體能更好地評估病情活動,對骨侵蝕具有更好的預(yù)測價值。2.RA患者血清中抗MCV抗體及抗CCP抗體與患者心理健康狀態(tài)、年齡、患病時間無關(guān),病情較重、抑郁傾向明顯的患者在日常生活中更傾向于消極應(yīng)對。
[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，

本文編號：2005363