[1]胡贵琦,吕梦宇,孙青阳,等.类风湿性关节炎患者血清中RF-CIC解离后RF水平检测及其应用价值研究[J].现代检验医学杂志,2025,40(06):181-184,189.[doi:10.3969/j.issn.1671-7414.2025.06.033]
　HU Guiqi,LYU Mengyu,SUN Qingyang,et al.Application Value Research and Detection of RF after RF-CIC Dissociation in the Serum of Rheumatoid Arthritis Patients[J].Journal of Modern Laboratory Medicine,2025,40(06):181-184,189.[doi:10.3969/j.issn.1671-7414.2025.06.033]
点击复制

类风湿性关节炎患者血清中RF-CIC解离后RF水平检测及其应用价值研究()

《现代检验医学杂志》[ISSN:/CN:]

卷:
第40卷
期数:
2025年06期
页码:
181-184,189
栏目:
论著
出版日期:
2025-11-15

文章信息/Info

Title:
Application Value Research and Detection of RF after RF-CIC Dissociation in the Serum of Rheumatoid Arthritis Patients
文章编号:
1671-7414（2025）06-181-05
作者:
胡贵琦1,2，吕梦宇2，孙青阳2，王 月2，宋 蕊2，戴玉柱2，成 军2，车飞虎2
1.蚌埠医科大学检验医学院，安徽蚌埠233000;2.中国人民解放军联勤保障部队第九〇三医院检验科，杭州 310013
Author(s):
HU Guiqi1,2，LYU Mengyu2，SUN Qingyang2，WANG Yue2，SONG Rui2，DAI Yuzhu2，CHENG Jun2，CHE Feihu2
1.School of Laboratory Medicine, Bengbu Medical University, Anhui Bengbu 233000, China;2.Department of Clinical Laboratory, the 903rd Hospital of the People’s Liberation Army, Hangzhou 310013, China
关键词:
类风湿因子; 类风湿性关节炎; 循环免疫复合物; 抗体解离技术
分类号:
R593.22；R392.11
DOI:
10.3969/j.issn.1671-7414.2025.06.033
文献标志码:
A
摘要:
目的?基于血清循环免疫复合物（CIC）解离技术，检测类风湿因子免疫复合物（RF-CIC）解离后类风湿因子（RF）含量，并探讨其在风湿性关节炎（RA）中的应用价值。方法选取2024年1～12月联勤保障部队第九〇三医院诊治的RA患者55例为RA疾病组，同时选取健康体检者20例为对照组，并收集与RA症状相近其他疾病患者［系统性红斑狼疮(SLE)、痛风、强直性脊柱炎(AS)、骨关节炎等患者］57例作为非RA疾病组。采用CIC解离技术处理三组研究对象的血清样本，检测RF-CIC解离后的RF含量，同时使用生化分析仪检测所有研究对象血清中的C反应蛋白（CRP）和RF水平。比较三组研究对象血清RF-CIC的阳性率及水平差异，并分析RF-CIC与炎性指标的相关性。结果RA疾病组、非RA疾病组、对照组血清中RF-CIC阳性率分别为87.27%（48/55），10.53%（6/57），0.0%（0/20），组间差异具有统计学意义（χ2=84.520，P<0.05）。进一步亚组分析显示，RF阴性亚组RA疾病组患者RF-CIC阳性率[61.11%（11/18）]高于非RA疾病组[1.92%（1/52）]和对照组[0%（0/20）]，差异具有统计学意义（χ2=44.493，21.671，均P<0.05）。RA疾病组RF阳性患者RF-CIC阳性率高于RF阴性患者（100%vs61.11%），差异具有统计学意义（χ2=16.487，P<0.05）。RA疾病组RF阳性患者血清中RF-CIC含量高于RF阴性患者[16.35（10.53，26.49]vs[3.57（2.53，3.89）]，差异具有统计学意义（Z=-4.243，P<0.05）。相关分析显示，RA疾病组患者血清中CRP和RF含量与RF-CIC含量呈正相关(r=0.490，0.970，均P<0.05)。结论RF阴性的RA患者血清中RF-CIC有较高的阳性率，且RF-CIC含量与炎性指标存在相关性。RF-CIC有望成为RA早期诊断及疾病活动性评估的血清学指标。
Abstract:
Objective To detect the content of rheumatoid factor(RF) after RF-CIC dissociation using serum circulating immune complexes(CIC) dissociation technology and evaluate its diagnostic and clinical value in rheumatic arthritis (RA). Methods 55 RA patients diagnosed and treated in the 903rd Hospital of the People’s Liberation Army from January 2024 to December 2024 were selected as the RA disease group, and 20 healthy individuals were selected as the control group. In addition, 57 non RA pa-tients with symptoms resembling RA[patients with systemic lupus erythematosus(SLE), gout, ankylosing spondylitis(AS), osteo-arthritis, etc) ]as the non RA disease group. Using CIC dissociation technology, RF content after RF-CIC dissociation was detect-ed in the serum of all three groups of study subjects, and C-reactive protein (CRP) and RF levels in all subjects were detected using a biochemical analyzer. Analyzed and compared the differences in the positive rate and levels of RF-CIC among three groups object of study. In addition, analyze and compare the correlation between RF-CIC and inflammatory index CRP. Results The positive rates of RF-CIC in the serum of RA disease group, non RA disease group, and control group were 87.27% (48/55), 10.53% (6/57) and 0.0% (0/20), respectively, and the differences between the three groups was statistically significant (χ2=84.520, P<0.05). Further subgroup analysis showed that the RF-CIC positivity rate in the RF negative subgroup of RA disease patients [61.11% (11/18)] higher than that in the non RA disease group [1.92% (1/52)] and the control group [0% (0/20)], and the differ-ences were statistically significant (χ2=44.493, 21.671, all P < 0.05）。 The RF-CIC positivity rate was higher in RF positive pa-tients than in RF negative patients in the RA disease group(100% vs 61.11%), and the difference was statistically significant(χ2=16.487, P<0.05). The RF-CIC content in the serum of RF positive patients in the RA disease group was higher than that of RF negative patients[16.35(10.53, 26.49) vs 3.57(2.53, 3.89)], and the difference was statistically significant (Z=-4.243, P<0.05). Correlation analysis showed that the levels of CRP and RF in the serum of RA patients were positively correlated with the levels of RF-CIC (r =0.490, 0.970, all P<0.05). Conclusion RF-CIC demonstrates high positivity even in RF-negative RA patients, and their levels correlate with CRP. RF-CIC shows potential as a serological indicator for early diagnosis and disease activity assess-ment in RA.

参考文献/References:

[1] FINCKH A, GILBERT B, HODKINSON B, et al. Global epidemiology of rheumatoid arthritis[J]. Nature Reviews Rheumatology, 2022, 18(10): 591-602.
[2] LIN J Z, ZHU Y Y, LI Q H, et al. Rheumatoid arthritis real-world cohort study in China (ReALSA): proto-col for a multicentre prospective, longitudinal cohort study[J]. BMJ Open, 2025, 15(7): e092583.
[3] YATES M, LEDINGHAM J M, HATCHER P A, et al. Disease activity and its predictors in early inflammatory arthritis: findings from a national cohort[J]. Rheumatol-ogy (Oxford, England), 2021, 60(10): 4811-4820.
[4] SMOLEN J S, LANDEW? R B M, BERGSTRA S A, et al. EULAR recommendations for the management of rheumatoid arthritis with synthetic and biological disease-modifying antirheumatic drugs: 2022 update[J]. Annals of the Rheumatic Diseases, 2023, 82(1): 3-18.
[5] DI MATTEO A, BATHON JM, EMERY P. Rheumatoid arthritis[J]. Lancet, 2023 , 402(10416): 2019-2033.
[6] BROWN P, PRATT A G, HYRICH K L. Therapeutic ad-vances in rheumatoid arthritis [J]. BMJ, 2024, 384: e070856.
[7] GRAVALLESE E M, FIRESTEIN G S. Rheumatoid arthri-tis - common origins, divergent mechanisms [J]. The New England Journal of Medicine, 2023, 388(6): 529–542.
[8] FIGUS F A, PIGA M, AZZOLIN I, et al. Rheumatoid arthritis: extra-articular manifestations and comorbidi-ties[J]. Autoimmunity Reviews, 2021, 20(4): 102776.
[9] SENAVEENIN N, MAHAKKANUKRAUH A, FOO-CHAROEN C, et al. Incidence and prevalence of rheumatoid arthritis in Thailand based on National ad-ministrative health data and a comprehensive literature review[J]. Scientific Reports, 2025, 15(1): 20665.
[10] WANG T, ZHANG M, ZHOU H J, et al. Establishment and evaluation of a general dissociation technique for antibodies in circulating immune complexes[J]. Clinical and Experimental Medicine, 2019, 19(1): 65-75.
[11] 陶昭君,成军,戴玉柱.甲状腺疾病患者血清Tg-CIC中Tg-Ab水平检测及相关临床研究[J].现代检验医学杂志, 2020, 35(6): 28-32. TAO Z J, CHENG J , DAI Y Z. Detection and related clini-cal research of Tg-Ab in serum thyroglobulin immune com-plex (Tg-CIC) in patients with thyroid diseases[J]. Journal of Modern Laboratory Medicine, 2020, 35(6): 28-32.
[12] HU K Q, CUI W . Persistence of circulating hepatitis C virus antigens-specific immune complexes in patients with resolved HCV infection[J]. Digestive Diseases and Sciences, 2018, 63(5): 1237-1242.
[13] 中华医学会风湿病学分会.2018中国类风湿关节炎诊疗指南[J].中华内科杂志, 2018, 57(4): 242-251. Chinese Rheumatology Association. 2018 Chinese guideline for the diagnosis and treatment of rheumatoid arthritis [J]. Chinese Journal of Internal Medicine, 2018, 57(4): 242-251.
[14] 成军,戴玉柱,江晓肖,等。一种免疫复合物缓冲解离剂及其应用:CN201410033277.4[P/OL]. 2014-01-23 [2025-07-22]. https://cprs.patentstar.com.cn/Search/Detail?ANE=8FBA7HAA9EHD9HBD6BEA9DG-A7BGA8CDA9DHE9GDCAEGA9EEG.
CHENG J , DAI Y Z, YAN L , et al. An immune complex dissociation buffer agent and its application, CN: ZL 2014 10033277.4[P/OL]. 2014-01-23 [2025-07-22]. https://cprs.patentstar.com.cn/Search/De-tail?ANE=8FBA7HAA9EHD9HBD6BEA9DGA7B-GA8CDA9DHE9GDCAEGA9EEG.
[15] 成军,孙长贵,戴玉柱,等.一种用于免疫复合物缓冲解离剂的CIC复溶剂:CN:ZL 201410034039.5 [P] .2014-05-07[2025-07-22]. CHENG J , SUN C G , DAI Y Z , et al. An immune com-plex dissociation buffer agent-CIC complex solvent, CN:ZL201410034039.5[P]. 2014-05-07[2025-07-22].
[16] 陈建芸,廖海平,孙朝晖,等.类风湿性关节炎患者血清RA-CP,抗CCP抗体及RF检测对RA的实验诊断意义[J].现代检验医学杂志, 2020, 35(5): 38-40, 50. CHEN J Y , LIAO H P , SUN C H , et al. Significance of the detection of RA-CP, anti CCP antibody, and RF in the laboratory diagnosis of rheumatoid arthritis[J]. Journal of Modern Laboratory Medicine, 2020, 35(5): 38-40, 50.
[17] MARTINEZ-PRAT L, NISSEN M J, LAMACCHIA C, et al. Comparison of serological biomarkers in rheumatoid arthritis and their combination to improve diagnostic per-formance [J]. Frontiers in Immunology, 2018, 9: 1113.
[18] SCHERER H U, H?UPL T, BURMESTER G R. The etiology of rheumatoid arthritis [J]. Journal of Autoim-munity, 2020, 110: 102400.
[19] GHANG B, PARK J K, JU J H, et al. Current state and fu-ture directions of basic research in rheumatoid arthritis [J]. Journal of Rheumatic Diseases , 2025, 32(3): 166-181.
[20] TANG C L, FANG M , TAN G J, et al. Discovery of novel circulating immune complexes in lupus nephritis using immu-noproteomics [J]. Frontiers in Immunology, 2022, 13: 850015.
[21] YAN Y , SUN H Z , CHANG L , et al. Circulating immune complexes and mutations of HBsAg are asso-ciated with the undetectable HBsAg in anti-HBs and HBeAg positive occult hepatitis B virus infection [J]. Frontiers in Microbiology, 2022, 13: 1063616.
[22] SUN Y J, XU Z J, XIE X Y, et al. An effective pre-treat-ment method for eliminating interference by serum albumin for analysis of anti-rHSA antibodies [J]. Ana-lytical Methods, 2023, 15(9): 1116-1122.
[23] 焦荣红,沈海涛,王淑芬,等.类风湿关节炎患者血清淀粉样蛋白A和C反应蛋白水平与疾病活动度的关系[J].现代检验医学杂志,2019,34(1):55-57, 61. JIAO R H , SHEN H T , WANG S F , et al. Relationship between serum amyloid A and C-reactive protein in patients with rheumatoid arthritis and activity of disease[J]. Journal of Modern Laboratory Medicine, 2019, 34(1): 55-57, 61.

相似文献/References:

[1]欧水连,潘志锋,徐灼均,等.基质金属蛋白酶-9在类风湿性关节炎中的诊断价值研究[J].现代检验医学杂志,2016,31(03):81.[doi:10.3969/j.issn.1671-7414.2016.03.022]
　OU Shui-lian,PAN Zhi-feng,XU Zhuo-jun,et al.Assessing the Role of Matrix Metalloproteinase-9 in Rheumatoid Arthritis[J].Journal of Modern Laboratory Medicine,2016,31(06):81.[doi:10.3969/j.issn.1671-7414.2016.03.022]
[2]赵辉.抗CCP抗体，AKA与RF联合检测在类风湿关节炎诊断中的临床意义[J].现代检验医学杂志,2015,30(05):159.[doi:10.3969/j.issn.1671-7414.2015.05.051]
　ZHAO Hui.Clinical Significance of Anti-CCP Antibody and Anti-AKA Antibody and Rheumatoid Factor in Rheumatoid Arthritis[J].Journal of Modern Laboratory Medicine,2015,30(06):159.[doi:10.3969/j.issn.1671-7414.2015.05.051]
[3]卢春利,刘小玲,曹团平,等.幼年类风湿关节炎患者中抗CCP抗体和RF，AKA，APF的相关性分析[J].现代检验医学杂志,2015,30(06):136.[doi:10.3969/j.issn.1671-7414.2015.06.042]
　LU Chun-li,LIU Xiao-ling,CAO Tuan-ping,et al.Analysis on the Correlation of Anti-CCP Antibody and RF，AKA，APF in JRA[J].Journal of Modern Laboratory Medicine,2015,30(06):136.[doi:10.3969/j.issn.1671-7414.2015.06.042]
[4]罗改莹,王 瑞,周 辉,等.类风湿性关节炎患者血清RF-IgM,RF-IgG检测的临床诊断价值[J].现代检验医学杂志,2018,33(06):43.[doi:10.3969/j.issn.1671-7414.2018.06.011]
　LUO Gai-ying,WANG Rui,ZHOU Hui,et al.Clinical Diagnostic Value of Serum RF-IgM and RF-IgG in Patients with Rheumatoid Arthritis[J].Journal of Modern Laboratory Medicine,2018,33(06):43.[doi:10.3969/j.issn.1671-7414.2018.06.011]
[5]冯 婧,喻晓雯,吴 斌,等.血清多项自身抗体检测对类风湿关节炎的诊断价值[J].现代检验医学杂志,2019,34(05):9.[doi:10.3969/j.issn.1671-7414.2019.05.003]
　FENG Jing,YU Xiao-wen,WU Bin,et al.Diagnostic Value of Serum Multiple Autoantibodies in Rheumatoid Arthritis[J].Journal of Modern Laboratory Medicine,2019,34(06):9.[doi:10.3969/j.issn.1671-7414.2019.05.003]
[6]王 娟,马飞艳,樊 萍.血清ASM 与GPx 水平检测与类风湿性关节炎膝关节病变的相关性研究[J].现代检验医学杂志,2020,35(04):61.[doi:10.3969/j.issn.1671-7414.2020.04.015]
　WANG Juan,MA Fei-yan,FAN Ping.Study on the Relationship between Serum Levels of ASM and GPx, and Rheumatoid Arthritis[J].Journal of Modern Laboratory Medicine,2020,35(06):61.[doi:10.3969/j.issn.1671-7414.2020.04.015]
[7]雷明玲,彭常基,张肄鹏,等.深圳地区类风湿关节炎患者 IL-17A 基因 rs2275913 位点多态性与血清中 IL-17A，IL-38 水平表达的相关性研究[J].现代检验医学杂志,2021,36(03):19.[doi:10.3969/j.issn.1671-7414.2021.03.005]
　LEI Ming-ling1,PENG Chang-ji2,ZHANG Yi-peng1,et al.Study on the Correlation between rs2275913 Polymorphism of IL-17A Geneand Serum IL-17A and IL-38 Expression in Patients with RheumatoidArthritis in Shenzhen Area[J].Journal of Modern Laboratory Medicine,2021,36(06):19.[doi:10.3969/j.issn.1671-7414.2021.03.005]
[8]孙莹莹,常丽辉,苗文霞.老年急性ST段抬高型心肌梗死患者血清RF，Cys-C水平与直接PCI术后无复流的关系[J].现代检验医学杂志,2022,37(02):184.[doi:10.3969/j.issn.1671-7414.2022.02.037]
　SUN Ying-ying,CHANG Li-hui,MIAO Wen-xia.Correlation between Serum RF, Cys-C Levels and No-reflow after Primary PCI in Elderly Patients with Acute ST-segment Elevation Myocardial Infarction[J].Journal of Modern Laboratory Medicine,2022,37(06):184.[doi:10.3969/j.issn.1671-7414.2022.02.037]
[9]陈建芸,廖海平,孙朝晖,等.类风湿性关节炎患者血清RA-CP，抗CCP 抗体及RF 检测对RA 的实验诊断意义[J].现代检验医学杂志,2020,35(05):38.[doi:10.3969/j.issn.1671-7414.2020.05.010]
　CHEN Jian-yun,LIAO Hai-ping,SUN Zhao-hui,et al.Significance of the Detection of RA-CP, Anti-CCP Antibody and RF in the Laboratory Diagnosis of Rheumatoid Arthritis[J].Journal of Modern Laboratory Medicine,2020,35(06):38.[doi:10.3969/j.issn.1671-7414.2020.05.010]

备注/Memo

备注/Memo:
基金项目：浙江省医药卫生科技计划项目(2021KYB941)。
作者简介：胡贵琦（1999-），女，在读硕士，研究方向：临床免疫学检验，E-mail：2024888211@qq.com。
通讯作者：车飞虎（1986-），男，硕士，主管技师，研究方向：临床感染性疾病实验室诊断，E-mail：chefeihu1986@163.com。
更新日期/Last Update: 2025-11-15