目的:研究循环游离DNA(cell-free DNA,cfDNA)在类风湿关节炎(rheumatoid arthritis,RA)患者外周血中含量对RA早期诊断和疾病活动度的评估价值,探讨cfDNA含量与RA的免疫学诊断指标及疾病活动度评估的相关指标类风湿因子(rheumatoid factor,RF)、抗环瓜氨酸抗体(anti-cyclic citrullinated peptide antibodies,抗CCP抗体)、C反应蛋白(C-reactive protein,CRP)、红细胞沉降率(erythrocyte sedimentation rate,ESR)和28个关节疾病活动指数评分(disease activity score of 28 joints,DAS28-ESR)间的关系。方法:收集80例初诊且未接受抗风湿类药物治疗的RA患者为观察组(RA组),40例健康人为对照组(HC组),收集两组血清,测定cfDNA含量并计算完整度,与收集的RA患者临床指标进行相关性分析。结果:RA组的cfDNA高于HC组(P＜0.05),但与诊断性血清学指标不相关(P＞0.05)。根据28个关节疾病活动指数评分(DAS28-ESR评分)对RA患者进行疾病活动度分层,发现cfDNA含量在DAS28-ESR评分高组高于评分低组(P＜0.05),cfDNA与DAS28-ESR、CRP和ESR具有相关性(P＜0.05)。结论:血清cfDNA在RA患者体内含量增加,与炎症反应有相关性,对RA有诊断价值,可能是RA致病的独立危险因素。
Objective: To investigate the value of circulating cell-free DNA (cfDNA) in the early diagnosis and disease activity of patients with rheumatoid arthritis (RA). To explore the relationship between cfDNA content and immunological diagnostic indicators of RA and related indicators of disease activity evaluation (rheumatoid factor (RF), Anti-cyclic citrullinated peptide antibodies (anti-CCP antibodies), C-reactive protein (CRP), Erythrocyte sedimentation rate (ESR)) and Disease Activity Score of 28 joints (DAS28-ESR). Methods: A total of 80 newly diagnosed RA patients who did not receive anti-rheumatic drugs were selected as the observation group (RA group), and 40 healthy people were selected as the control group (HC group). The serum cfDNA content of two groups was measured and the integrity was calculated. The correlation between cfDNA content and clinical indicators of RA patients was analyzed. Results: The RA group had a significantly higher level of cfDNA than the HC group (P＜0.05), but there was no correlation between and diagnostic serological markers (P＞0.05). According to the disease activity index of 28 joints (DAS28-ESR score), RA patients were stratified by disease activity, and it was found that the cfDNA content in the high DAS28-ESR score group was higher than that in the low DAS28-ESR score group (P＜0.05). cfDNA was correlated with DAS28-ESR, CRP and ESR (P＜0.05). Conclusion: The content of serum cfDNA in RA patients is increased, which is correlated with inflammatory response. It has diagnostic value for RA and may be an independent risk factor for the pathogenesis of RA.
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