Clinical Study On Correlation Between Anti-CCP Antibody And Rheumatoid Arthritis Related Interstitial Lung Disease And Micro Syndrome Differentiation Of TCM

Objective: We try to explore the correlation between anti-CCP antibody and the incidence of RA related ILD,and the effect of anti-CCP antibody on TCM syndrome elements of patients who have detected the antibody,in order to provide theoretical basis for TCM Micro syndrome differentiation corresponding to anti-CCP antibody.Methods: Based on the hospital information system(HIS),a retrospective study was conducted to collect data on gender,age,history of cardiovascular and cerebrovascular diseases,history of diabetes,smoking or dust exposure,heart rate,and laboratory indexes(RF,AKA,ANA,routine blood test,CRP,ESR)and TCM syndrome elements in 223 inpatients who were tested for anti-CCP antibodies from January 2019 to June 2021 in the Second Affiliated Hospital of Tianjin University of Traditional Chinese Medicine.Put the above information into Excel table to establish patient database,and use SPSS25.0 software to analyze measurement data by rank sum test,counting data by chi square test.Spearman correlation analysis was used to judge the correlation.And logistic regression analysis was used to judge the relevant factors affecting the prognosis.Grouping: 1 223 patients were divided into negative group(< 6AU / m L),low titer group(6 ～ 300 AU / m L)and high titer group(> 300 AU / m L)according to the level of anti-CCP antibody.The differences of general data,relevant laboratory indexes and disease incidence of the three groups were analyzed.2 According to whether the patients have RA or not,223 patients are divided into RA group and non-RA group.The general data,laboratory indexes and TCM syndrome factors of these patients are statistically analyzed to judge the influencing factors of RA.3 According to whether the patients diagnosed with RA have RA-ILD,the 107 patients with RA are divided into RA-ILD group and simple RA group.The general data,laboratory indexes and TCM syndrome elements of these patients are statistically analyzed to judge the influencing factors of RA-ILD compared with simple RA.4 107 patients with RA were selected and grouped according to their anti-CCP antibody level to explore the correlation between anti-CCP antibody and general data,relevant laboratory indexes and TCM syndrome elements.5 According to whether there is a certain TCM syndrome element grouping,analyze the influence of patients’ general data and laboratory indicators on TCM syndrome elements.Results: 1.Study on the correlation of anti-CCP antibody: The level of anti-CCP antibody was significantly correlated with HGB(r =-0.173),ILD(r = 0.177)(P < 0.05),ANA antibody(r = 0.320),AKA antibody(r = 0.547),RF(r = 0.692),RA(R = 0.763)and RA-ILD(r = 0.500)(P < 0.001).2 Influencing factors of RA: Univariate analysis showed that age,anti-CCP antibody,RF,ANA,AKA,HGB,Yin deficiency syndrome element and fire heat syndrome element had statistical significance for the incidence of RA.The results showed that the increase of anti-CCP antibody(OR=10.482,95% CI 5.006-21.947)and RF(OR = 1.005,95% CI1.001-1.008)were the risk factors of RA.3 Influencing factors of RA-ILD in patients with RA: Univariate analysis showed that anti-CCP antibody and water dampness syndrome element had statistical significance for RA-ILD in RA patients(P < 0.05).The results showed that water dampness syndrome element(OR=0.354,95% CI 0.153 ～ 0.821)was the protective factor of RA-ILD in RA patients.4 Study on the correlation of anti-CCP antibody in patients with RA: The level of anti-CCP antibody in patients with RA was correlated with AKA(r = 0.208)and smoking or dust exposure history(r = 0.280)(P < 0.05).5 Influencing factors of TCM Syndrome Elements5.1 Yin deficiency syndrome: The results of univariate analysis showed that ANA,RF,cardiovascular and cerebrovascular history and anti-CCP antibody had statistical significance for patients with Yin deficiency syndrome(P < 0.05).The results showed that the increase of anti-CCP antibody(OR=1.676,95% CI 1.131-2.485)was the risk factor of Yin deficiency syndrome.5.2 Water dampness syndrome: Univariate analysis showed that RF,AKA and diabetes history were statistically significant in patients with water wet syndrome(P < 0.05).The results showed that AKA positive(OR=2.046,95% CI 1.049-3.990)was the risk factor of water dampness syndrome.5.3 Fire and heat syndrome: Univariate analysis showed that the inclusion of RF,AKA,anti-CCP antibody,CRP and WBC had statistical significance for patients with fire heat syndrome(P < 0.05).The results showed that AKA positive(OR=0.284,95% CI 0.102-0.790)was the protective factor of fire heat syndrome.Conclusion: 1 High level of anti-CCP antibody is related to positive ANA,positive AKA,increased RF,decreased HGB,incidence of RA,incidence of ILD and incidence of RA-ILD.2 The history of smoking or dust exposure and positive AKA are correlated with the level of anti-CCP antibody in RA patients.3 The increase of anti-CCP antibody and RF are the risk factors of RA.4 Water dampness syndrome element is the protective factor of RA-ILD in patients with simple RA.5 The increase of anti-CCP antibody is the risk factor of Yin deficiency syndrome.