类风湿性关节炎中抗环瓜氨酸肽抗体的检测

The Diagnostic Value of Anti-Cyclic Citrullinated Peptide Antibody in Patients with Rheumatoid Arthritis

目的检测类风湿性关节炎患者(rheumatoidarthritis,RA)血清中的环瓜氨酸肽(cycliccitrullinatedpeptide,CCP)抗体,探讨其在RA诊断中的价值。方法用ELISA方法分别检测53例RA、59例非RA和30例正常献血员中CCP抗体;用间接免疫荧光法和速率散射比浊法同期检测抗角蛋白抗体(anti-keratinantibody,AKA)和类风湿因子(rheuma-toidfactor,RF),分析CCP抗体的检测结果以及与AKA、RF的相关性。结果53例RA患者CCP抗体的阳性率为88.68%,59例非RA患者为5.1%,正常献血员全部阴性。三种抗体对RA的敏感性和特异性分别为CCP88.68%,96.63%;AKA62.26%,94.38%;RF90.57%,78.65%。CCP抗体与AKA检测阳性率之间差异显著,与RF差异不显著。这三种方法的检测结果不相关。结论ELISA方法检测CCP抗体简便、标准、结果可靠,对RA具有高度的敏感性和特异性,值得临床推广应用。

Objective To detect anti-cyclic citrullinated peptide(CCP) antibody in patients with rheumatoid arthritis(RA) and explore its diagnostic value.Methods Anti-CCP antibodies were examined by an ELISA from 53 RA,59 non-RA patients and 30 normal donors sera.Anti-keratin antibody (AKA) were detected by indirect immunofluorescence(IIF).Rheumatoid factor(RF) were assayed by rate nephelometry method.Results were analysed by comparing the correlations among the anti-CCP,AKA and RF.Results Among 53 patients with RA,47 patients showed positive of anti-CCP(88.68%).Whereas,the positive percent was only 5.1% in 59 non-RA patients.The sensitivity and specificity of anti-CCP,AKA and RF were 88.68% and 96.63%;62.26% and 94.38%;90.57% and 78.65% in RA respectively.The data showed there was a significant difference between the two methods of anti-CCP and AKA assaying.However,no difference was found between anti-CCP and RF assaying.Anti-CCP was not related to AKA and RF.Conclusion Detecting anti-CCP by ELISA may be a brief,standard and reliable method.It might present more sensitive and specific in clinical diagnosis on RA.