抗环瓜氨酸肽抗体、类风湿因子与抗角蛋白抗体在类风湿关节炎诊断中的价值比较

Comparison of the value of anti-cyclic citrullinated peptides,rheumatoid factor and antikeratin antibody in the diagnosis for rheumatoid arthritis

目的比较抗环瓜氨酸肽(CCP)抗体、类风湿因子(RF)与抗角蛋白抗体(AKA)在类风湿性关节炎(RA)诊断中的作用。方法对118例(RA 61例,非RA 57例)患者血清同时进行抗CCP抗体、RF和AKA检测,检测方法分别为酶联免疫吸附试验(ELISA)、BECKMAN全自动蛋白分析仪、间接免疫荧光法。结果RA组中3种抗体的阳性率显著高于非RA组(P<0.01);抗CCP抗体对RA诊断的敏感性(67.2%)明显高于AKA(41.6%,P<0.01),且两者显著相关(P=0.004),与RF(77.0%)差异无显著性;抗CCP抗体对RA诊断的特异性(94.7%)明显高于RF(73.7%,P<0.01)与AKA(91.2%),差异无显著性;抗CCP抗体和RF联合检测的敏感性达90.2%。结论抗CCP抗体有适度的敏感性和很高的特异性,对诊断RA具有良好的应用价值;联合检测抗CCP抗体和RF具有更高的敏感性。

Objective To evaluate the value of anti-cyclic citmllinated peptides（anti-CCP） for rheumatoid arthritis （RA） by comparison with rheumatoid factor（RF） and antikeratin antibody（AKA）. Methods The sera of 118 patients （61 RA and 57 nor-RA） were tested for anti-CCP, RF and AKA by enzyme linked immunosorbent assay （ELISA）, BECKMAN antomated protein analysis system, indirect immunofluorescence assay （IIF） respectively. Results The positive rates of the three antibodies in RA group were significantly higher than those in non-RA group （P 〈 0.01 ）. The sensitivity of anti-CCP （67.2%） for RA was significantly higher than that of AKA （41.6%） （P 〈0.01 ）, and there was a significant correlation between them （P = 0. 004）, there was no significant difference in comparison with RF. The specificity of anti-CCP （94.7%） was significantly higher than that of RF （73.7%） （P 〈0, 01 ）, there was no significant difference in comparsion with AKA. The presence of the combinational test for both anti-CCP and RF reached 90. 2%. Conclusions The detection of anti-CCP is useful to the diagnosis of RA because of its moderate sensitivity and higher specificity. The combination testing of anti-CCP and RF has a higher sensitivity.