| 1 Objects1.1 To study serum glucose-6 phosphate isomerase(GPI) level from RA patients, other rheumatologic patients, non-rheumatologic patients and healthy controls. Discuss the role of glucose-6 phosphate isomerase in diagnosis of RA.1.2 To assess the diagnostic significance of serum GPI, anti-Cyclic Citrullinated Peptide antibody(anti-CCP), anti-keratin antibody(AKA) and rheumatoid factor(RF) in the diagnosis of RA.1.3 To compare serum GPI, RF, erythrocyte sedimentation rate(ESR), C-reative protein(CRP) of RA patients. Evaluate the relationship among GPI and other factors.1.4 To study the variation of GPI,RF, ESR, CRP before and after treatment. Evaluate the role of GPI in curative effect evaluation of RA. Evaluate the effect of compound salvia m iltiorrhizal injection on GPI.2 Methods2.1 Used Enzyme-Linked Immuno Sorbent Assay to exam serum GPI level from 53 RA patients,35 other rheumatologic patients,30·non-rheumatologic patients and 60 healthy controls.The result of this study was compared.2.2 Used Enzyme-Linked Immuno Sorbent Assay to exam serum GPI level, anti-CCP, used indirect immunofluoresent assay to exam AKA, used turbidimetric immunoassay method to exam RF from 53 patients of RA. Sum up the sensitivity and specificity for diagnosis of RA.2.3 Used Enzyme-Linked Immuno Sorbent Assay to exam serum GPI level,used turbidimetric immunoassay method to exam RF and CRP, used westergren to exam ESR from 53 patients of RA. Sum up and compare the result.2.4 To exam serum GPI level, RF, ESR, CRP from 20 patients of RA before and after the treatment and compare the result. To compare serum GPI level before and after the treatment with othe hospital.3 Results3.1 Serum GPI level and the GPI positive rate from RA patients were 3.65±2.87ug/ml and 79.25%, from other rheumatologic patients were 0.96±1.74ug/ml and 40%, from non-rheumatologic patients were 0.40±0.99ug/ml and 20%. The GPI positive rate from healthy controls was 5%. Serum GPI level from RA patients was significantly higher than those from other rheumatologic patients and non-rheumatologic patients. There were significant difference among RA patients and other rheumatologic patients, non-rheumatologic patients. There were no difference between rheumatologic patients and non-rheumatologic patients.3.2 The sensitivity and specificity of GPI for diagnosis of RA were 79.25% and 69.23%;anti-CCP were 56.6% and 96.92%; AKA were 32.0% and 96.92%; RF were 71.7% and 89.23%. The sensitivity and specificity of the combined detection of GPI,anti-CCP and RF and/or AKA were 88.68% and 100%.3.3 Compared with RF, the r value was 0.6527. There were significant relationship between GPI and RF (P<0.01). While there were no relationship among GPI and ESR,CRP(P>0.05).3.4 The main clinical symptoms of the 20 RA patients were improved significantly after the treatment. Serum GPI level, ESR and CRP had no difference between before and after the treatment. Serum GPI level was degraded significantly but was conformity. Compared with other clinical research, the changement of serum GPI level was conformity.4 Conclusions4.1 GPI holds great promise as a diagnosis and differential diagnosis tool for RA. It may be a new index for diagnosis of RA.4.2 The combined detection of GPI, anti-CCP, AKA and RF have high sensitivity and specificity in diagnosis of RA. Thus the combined detection of these four antibodies may help the diagnosis of RA.4.3 GPI is shown to be significantly related to RF. RF plays a great role on the activity of RA. Thus, GPI holds great promise as a diagnosis tool for RA and its activity. It may be one of the index for activity of RA such as CRP.4.4 GPI is not shown to be significantly related in curative effect evaluation to RA. The GPI positive rate and serum GPI level from 20 RA patients is degraded significantly after the treatment of compound salvia m iltiorrhizal injection. Compound salvia m iltiorrhizal injection has certain impact on GPI. |
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