EDRA/CPA检测在类风湿性关节炎诊断中的应用

Clinical Utility of EDRA/CPA in the Diagnosis of Rheumatoid Arthritis

目的:探讨检测瓜氨酸合成蛋白抗体(EDRA/CPA)对类风湿性关节炎(RA)诊断的价值。方法:EDRA/CPA、环瓜氨酸肽抗体(抗-CCP)均采用ELISA法检测,类风湿因子(RF)应用散射免疫比浊法检测。共检测确诊RA患者124例,其他关节病患者108例。结果:EDRA/CPA、抗-CCP、RF3种抗体的敏感性和特异性分别为65.3%和98.1%,54.8%和95.3%,74.2%和75.9%。EDRA/CPA与抗-CCP两者之间和RF之间均具有相关性,与抗-CCP的关联强度更高,但不完全重叠。EDRA/CPA与RF联合检测的阳性率为85.5%(106/124)。早期RA患者EDRA/CPA和抗-CCP敏感性高于中、晚期患者。而早期RA患者RF的敏感性却显著低于中、晚期患者。结论:EDRA/CPA对RA诊断具有高度的特异性和良好的敏感性,优于抗-CCP,可作为RA早期诊断指标。

Objective To explore the value of clinical utility of citrullinated protein IgG antibodies EDRA/CPA in the diagnosis of rheumatoid arthritisRA. Methods Citrullinated protein IgG antibodies and anti-cyclic citrullinated peptide anti-CCP antibodies were detected by ELISA. Rheumatoid factor RF was detected by immunoturbidmetric assay. The concentrations of these three markers in 124 RA patients 108 non-RA controls with various arthritic diseases and 40 normal controls were examined. Results Eighty one of 124 RA patients were positive for EDRA/CPA with sensitivity 65.3% and specificity 98.1%. The sensitivity was highest for RF followed by EDRA/CPA and anti-CCP. The specificity was highest for EDRA/CPA followed by anti-CCP and RF. EDRA/CPA was associated with anti-CCP and RF. Both EDRA/CPA and RF in 124 RA patients were detected sensitivity 85.5%106/124. Conclusion EDRA/CPA is a new antibody for diagnosing of RA and may enhance the early diagnositic rate of RA when combined with detecting RF.