抗环瓜氨酸肽抗体检测对老年人类风湿性关节炎的诊断价值

Diagnostic value of anti-cyclic citrullinated peptide antibody in the elderly onset rheumatoid arthritis

目的探讨抗环瓜氨酸肽抗体(抗CCP抗体)及类风湿因子(RF)的检测对老年人类风湿性关节炎(EORA)的诊断价值。方法分别用ELISA法、速率散射比浊法检测52例RA患者和52例非RA的老年健康对照者的血清抗CCP抗体和RF。运用四格表和受试者工作特征曲线评估两者对EORA诊断效能。结果抗CCP抗体对EORA的敏感性、特异性和准确性分别为80.76%、96.15%及88.46%,阳性和阴性拟然比分别为21.00(95%CI,9.90-36.88)和0.20(95%CI,0.09-0.38)。RF诊断EORA的敏感性、特异性和准确性分别为73.07%、76.92%、72.22%,阳性和阴性拟然比分别为3.16(95%CI,1.53-10.42)和0.35(95%CI,0.19-0.64)。抗CCP抗体诊断准确性高于RF(P=0.023)。抗CCP抗体诊断EORA的ROC曲线下面积(AUC)为0.908(95%CI,0.848-0.969),优于RF(P<0.001)。结论抗CCP抗体对EORA具有较好的敏感性和很高的特异性,在诊断EORA时较RF有更高的价值。

【Objective】To evaluate the clinical diagnostic value of anti-cyclic citrullinated peptide (anti-CCP) antibody and rheumatoid factors in patients with elderly onset rheumatoid arthritis (EORA). 【Methods】Anti-CCP antibody was detected by quantitative ELISA and rheumatoid factor by BNP nephelometer in 52 cases of EORA and 52 health controls. The accuracy of anti-CCP antibody and RF examination for diagnosing the disease was com-pared. Receiver operating characteristic (ROC) curves were used to assess the diagnostic value of anti-CCP. 【Re-sults】The sensitivity,specificity and accuracy of the anti-CCP antibody diagnostic method were 80.76%,96.15% and 88.46%,respectively. Those of RF were 73.07%,76.92% and 72.22%,respectively. The positive and negetive-likelihood ratios for the anti-CCP antibody diagnostic method were 21.00 (95% CI,9.90-36.88) and 0.20 (95% CI,0.09-0.38); for RF,the values were 3.16 (95% CI,1.53-10.42) and 0.35 (95% CI,0.19-0.64),respectively. Area under ROC (AUC) in anti-CCP antibody examination was 0.908 (95% CI,0.848-0.969). 【Conclusion】Anti-CCP antibody examination is accurate in diagnosing EORA.