摘要
目的检测葡萄糖6-磷酸异构酶(glucose-6-phosphate isomerase,GPI)抗原在类风湿关节炎(rheumatoid arthritis,RA)中的表达情况,并比较其与类风湿因子(rheumatoid factor,RF)和第2代抗环瓜氨酸肽(thesecond generation of anti-cyclic citrullinated peptide,抗CCP2)抗体对RA的诊断价值。方法采用酶联免疫吸附试验检测126例RA和122例非RA患者血清GPI抗原和抗CCP2抗体,速率散射比浊法检测RF。结果血清GPI浓度在RA患者较非RA组显著增高,差异有统计学意义[(0.28±0.65)mgLvs.(0.07±0.36)mgL,P<0.005]。GPI对RA的诊断敏感性为32.5%,低于RF(69.0%)和抗CCP2抗体(72.2%)的诊断敏感性,差异均有显著统计学意义(P<0.001);GPI、RF和抗CCP2抗体对RA的诊断特异性分别为89.3%、87.7%和95.1%,差异无显著统计学意义(P>0.05)。与单一检测抗CCP2抗体比较,GPI及RF同时阳性、GPI及抗CCP2抗体同时阳性、以及GPI、RF及抗CCP2抗体三项同时阳性的诊断敏感性降低;而GPI或RF、GPI或抗CCP2、以及GPI或RF或抗CCP2单一阳性的诊断特异性降低,均有显著统计学意义(P<0.05)。结论血清GPI对RA诊断的敏感性低,可与高敏感性的抗CCP2抗体联合检测。
Objective To assess the diagnostic value of serum glucose-6-phosphate isomerase (GPI) antigen in rheumatoid arthritis (RA), and compared with rheumatoid factor (RF) and the second generation of anti-cyclic citrullinated peptide (CCP2) antibody. Methods Samples from 126 RA cases and 122 non-RA disease cases were tested. GPI and anti-CCP2 antibodies were detected by enzyme linked immunosorbent assay. Results The mean level of GPI was significantly higher in RA patients than that in non-RA group [ (0. 28 ± 0. 65 ) mg/L vs (0. 07 ± 0.36) mg/L, P 〈 0. 0051. GPI was significantly less sensitive than RF (32.5% vs 69.0%, P 〈 0. 001 ) and anti-CCP2 autoantibody (32.5% vs 72.2%, P 〈 0. 001 ) for RA. The specificity of GPI, RF and anti-CCP2 antibody for RA was 89.3%, 87.7% and 95.1% respectively. Compared with anti-CCP2 antibody, the combination assays of GPI, RF; GPI, anti-CCP2 and GPI + RF + anti-CCP2 showed significantly lower diagnostic sensitivity ( P 〈 O. 001 ) ; combination assays of GPI/RF, GPI/anti-CCP2 and GPI/RF/anti-CCP2 antibody demonstrated significantly lower diagnostic specificity (P 〈 0. 05 ). Conclusions GPI is less sensitive for RA, and anti-CCP2 antibody has been demonstrated to have very good sensitivity and high specificity.
出处
《中华临床免疫和变态反应杂志》
2013年第2期115-119,共5页
Chinese Journal of Allergy & Clinical Immunology