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目的 检测隐匿性IgM型类风湿因子 (HIgM RF)并探讨其在幼年类风湿关节炎 (JRA)中的临床意义。方法 利用聚乙二醇 (PEG)分离含类风湿因子 (RF)的免疫复合物 ,在酸性条件下解离出RF ,以酶联免疫吸附试验方法 ,测定HIgM RF。 6 8例JRA患儿中的 16例在活动期和缓解期HIgM RF ,与正常对照组 (35例 )比较。结果 (1)HIgM RF在JRA的阳性率为 71 4% ,其中多关节炎型阳性率为 80 0 % ,少关节炎型阳性率为 71 4% ,全身型阳性率 5 8 8%。 (2 )多关节炎型、少关节炎型、全身型JRA活动期HIgM RF均值高于缓解期 ,差异均具有非常显著意义 (t=11 15 ,t=14 6 7,t=5 78;P<0 0 1)。全组活动期JRA均值同正常对照组比较 ,差异有显著性 (F =16 34,P <0 0 1)。但缓解期均值同正常组比较差异未见显著性意义 (P >0 0 5 )。 (3)HIgM RF与血沉 (ESR)、C 反应蛋白 (CRP)正相关 (r=0 6 9,P <0 0 1;r=0 32 ,P <0 0 1)。同年龄、性别、病程无关。结论 HIgM RF在JRA中有较高的检出率 ,并与病情活动性有关 ,可作为JRA诊断、评估活动性的一个指标
Objective To detect the occult IgM rheumatoid factor (HIgM RF) and to explore its clinical significance in juvenile rheumatoid arthritis (JRA). Methods Polyethylene glycol (PEG) was used to isolate immune complexes containing rheumatoid factor (RF) and RF was dissociated under acidic conditions. HIgM RF was determined by enzyme - linked immunosorbent assay. Sixty-six children with JRA were active and remission HIgM RF, compared with the normal control group (n = 35). Results (1) The positive rate of HIgM RF in JRA was 71.4%. The positive rate of polyarthritis was 80%, the rate of less arthritis was 71.4%, and the positive rate of whole body was 58.8%. (2) The HIgM RF mean of multi-arthritis type, less arthritis type and whole body type JRA activity period were higher than that of remission stage, and the differences were very significant (t = 11 15, t = 14 6 7, t = 5 78; P <0 0 1). There was a significant difference between the JRA mean of the whole group and the normal control group (F = 1634, P <0.01). However, there was no significant difference between the mean of remission period and normal group (P> 0.05). (3) HIgM RF was positively correlated with ESR and CRP (r = 0 6 9, P <0.01; r = 0 32, P <0.01). With age, gender, duration of disease has nothing to do. Conclusion HIgM RF has a high detection rate in JRA and is related to the activity of the disease, which can be used as an indicator of the diagnosis and assessment of the activity of JRA