血清RF和抗CCP抗体浓度检测在类风湿性关节炎诊断中的临床意义

The Diagnostic Value of Serum RF and Anti-CCP in Patients with Rheumatoid Arthr itis

目的探讨血清中RF和抗CCP抗体浓度检测在类风湿性关节炎疾病诊断中的临床意义。方法以RA病患者117例、非RA患者86例、健康对照91例样本为试验材料,采用速率散射比浊法和酶联免疫吸附试验方法测定血清中RF和抗CCP抗体浓度。结果 RA组血清RF和抗CCP抗体浓度分别为58.81±21.76U/ml和22.47±10.55U/ml,阳性率分别为78.9%和73.5%,均显著高于非RA组和健康对照组(P<0.05)。ROC曲线分析发现,RF指标的敏感性和特异性分别为0.785和0.962,分别低于和高于CCP抗体指标(0.870和0.928);当使用RF/抗CCP抗体2个指标联合检测时,敏感性与特异性分别为0.947和0.911,敏感性有较大提高。结论血清中RF和抗CCP抗体浓度测定可用于RA疾病的临床诊断,但将RF与抗CCP抗体指标联合检测具有较高的敏感性。

Objective We examined the serum concentration of rheumatoid factor（RF） and anti-cyclic c itrullinated peptide antibody（anti-CCP） in patients with rheumatoid arthritis（RA） to evaluate the predictive value of clinical diagnose. Methods The rate nephelometry and ELISA methods were employed t o detect the ser um level of RF and anti-CCP in 294 subjects,including 117 RA patients,86 non-R A patients,and 91 health persons.Results The absolute concentra tion and posit ive rate of serum in RA group were 58.81±21.76 U/ml and 78.9% for RF,22.47±1 0.55 U/ml and 73.5% for anti-CCP,respectively,which were significantly hig her than those in non-RA patients and health persons（P〈0.05）.According to RO C analysis,the sensitivity and specificity were 0.785 and 0.962 for RA index an d 0.870 and 0.928 for anti-CCP,respectively.When the RF and anti-CCP were comb ined together for ROC analysis,the sensitivity and specificity were 0.947 and 0.911,respectively.Conclusion The serum levels of RF and Anti-C CP could be use d as biomarkers for RA diagnosis.However,the sensitivity value will be relati vely high when the RF and Anti-CCP were combined together for ROC analysis.