肥胖是一种以慢性低度炎症为特征的进展性疾病,与多种代谢性疾病的发生、发展密切相关。脂肪组织作为一种内分泌和免疫器官,可分泌多种生物活性物质及炎症因子,参与肥胖患者体内的代谢过程。减重手术是治疗病态性肥胖及相关代谢性疾病的有效方法之一,能够调节机体内的炎症反应、有效改善代谢状态。但减重手术对于炎症因子的作用如何,目前国内外的文献证据仍有争议。本文将系统阐述肥胖与代谢性炎症的关系以及减重手术对炎症因子的影响,旨在为肥胖代谢外科的诊疗过程提供参考。

Obesity is a progressive disease characterized by chronic low-grade inflammation,which is closely related to the occurrence and development of a variety of metabolic diseases．As an endocrine and immune organ,adipose tissue can secrete a variety of bioactive substances and inflammatory factors,which participate in the metabolic process of obese patients．Bariatric surgery is one of the effective methods for the treatment of morbid obesity and related metabolic diseases,which can regulate the inflammatory response in the machine and effectively improve the metabolic state．However,the effect of bariatric surgery on inflammatory factors is still controversial at home and abroad．This article will systematically explain the relationship between obesity and metabolic inflammation and the effect of bariatric surgery on inflammatory factors,aiming to provide a reference for the diagnosis and treatment process of bariatric surgery．

目的 分析抗中性粒细胞胞浆抗体(ANCA)阳性类风湿关节炎(RA)患者的临床及血清学特征。方法 回顾性比较分析2019—2020年本院住院113例核周型抗中性粒细胞胞浆抗体(P-ANCA)阳性及120例P-ANCA阴性RA患者的临床及实验室资料。结果 P-ANCA阳性组的抗环瓜氨酸肽(CCP)抗体为(171.47±130.48)U/mL,阴性组为(130.10±132.7)U/mL,t=2.250,P=0.026。阳性组的抗CCP抗体的阳性率为82/98(83.67%),阴性组为71/110(64.55%),χ²=9.749,P=0.003。阳性组CCP抗体高滴度率63/98(64.29%),阴性组为53/110(48.18%),χ²=5.449,P=0.025。阳性组的RF浓度:(205.14±276.08)U/mL,阴性组RF浓度:(136.94±201.51)U/mL,t=2.159,P=0.032;阳性组的RF阳性率为98/112(87.5%),阴性组的78/120(65.89%),χ²=16.016, P<0.001;阳性组的类风湿因子高浓度率73/112(64.60%),阴性组56/120(46.67%),χ²=8.042, P=0.005。结论 P-ANCA阳性的RA患者的抗体水平相对更高。

Objective To analyze the clinical and serological characteristics of rheumatoid arthritis (RA) patients with positive anti-neutrophil cytoplasmic antibodies (ANCA). Methods The clinical and laboratory data of 113 perinuclear-ANCA (P-ANCA) positive and 120 P-ANCA negative RA patients in our hospital from 2019 to 2020 were retrospectively analyzed. Results The anti-cyclic citrullinated peptide (CCP) antibody of P-ANCA positive group was (171.47±130.48) U/mL, and which in the negative group was (130.10±132.7) U/mL, t=2.250, P=0.026. The positive rate of anti-CCP antibodies in positive group was 83.67% (82/98), and that in the negative group was 64.55% (71/110), χ²=9.749, P=0.003. The high titre rate of CCP antibody in positive group was 64.29% (63/98), and that in the negative group was 53/110 (48.18%),χ²=5.449, P=0.025. The RF concentration of positive group was (205.14±276.08) U/mL, the negative group concentration was (136.94±201.51) U/mL, t=2.159, P=0.032; the RF-positive rate of positive group was 87.5% (98/112), 65.89% (78/120) in the negative group, χ²=16.016, P<0.001; the high concentration rate of rheumatoid factor in positive group was 73/112(64.60%), the negative group 56/120(46.67%), χ²=8.042, P=0.005. Conclusions RA patients with positive P-ANCA had relatively higher antibody levels.