| ObjectiveTo investigate the correlation of anto-immune antibodies and the kidney-deficiency type rheumatoid arthritis (RA). It would provide clinical evidence for the further research of molecular biology mechanism in RA patients with kidney-deficiency.MethodsThere were451patients with RA totally in this research,218cases with kidney-deficiency,233cases without kidney-deficiency. Statistical analysis was employed in general condition (gender, age, duration and age of onset), disease acticity (number of swollen joints, number of tender joints, erythrocyte sedimentation rate, C-reactive protein and disease activity score in28joints) and immune index (rheumatoid factor, anti-CCP antibody and anti-nuclear antibody).Results1. The percent of women is79%and men is21%. The ratio of men and women is1:3.7, the average age of patients is53.75years. These patients had7.02years average duration of RA, average onset age of46.73years. There are no differences statistically between two groups in gender, average age, average duration and average onset age(P>0.05).2. Patients who are older than49years account for67.63%. The proportion of RA with kidney-defucuency in each age paragraph, compared with overall, is not statistically significant (P>0.05).3. Patients with duration longer than2years account for68.16%. There is no differerce between two groups in the course constitute(P>0.05).4. Patients whose onset age is older than49years account for45.90%. Compared with overall, the proportion of RA with kidney-defucuency in each onset age paragraph is not statistically significant(P>0.05).5. The disease activity score in28joints is6.080in patients with kidney-deficiency. It is statistically higher than the score in patients without kidney-deficiency, which is5.598(P<0.01).6. Patients with high disease activity account for69.84%. In the group with high disease activity, the percent of kidney-deficiency type patients is53.65%. It is higher than36.89%which patients with kidney-deficiency account for in the group with low disease activity (P<0.01).7.90.24%of the patients are rheumatoid factor (RF) possitive, and72.90%among them are high level RF possitive. Compared with patients without kidney-deficiency (439.91RU/ml), the level of average RF of kidney-deficiency type patients(697.32RU/ml) is higher (P<0.05). The risk is as1.574times as patients without kidney-deficiency that kidney-deficiency type patients are high level RF possitive(P<0.05).8.87.36%of the patients are anti-CCP antibody possitive, and82.26%among them are high level anti-CCP antibody possitive. The average level of anti-CCP antibody is133.26IU/ml in kidney-deficiency type RA patients, and it is115.78IU/ml in RA patients without kidney-deficiency(P>0.05). There are no statistically significance that kidney-deficiency increase the risk of high level anti-CCP antibody (P>0.05).9.26.61%of the patients is ANA positive. Among RA patients with kidney-deficiency, the percent is33.9%. It is statistically significant that the percent is19.7%in RA patients without kidney-deficiency (P<0.01). The risk is as2.059times as patients without kidney-deficiency that kidney-deficiency type patients are ANA possitive (P<0.05).ConclutionKidney-deficiency is one of the most important factors to the occurrence and development of RA. Kidney-deficiency type RA is more serious. The incidence is higher that the RA patients with kidney-deficiency have higher level of RF or ANA positive. It prompts that Kidney-deficiency type RA may progress faster, more serious joint destruction and poorer prognosis. There is a close relationship between the dysfunction of autoimmune tolerance in B cells and the occurrence and development of RA with kidney-deficiency. |
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