抗环瓜氨酸肽抗体等四种抗体在早期类风湿关节炎诊断中的意义

Specific antibodies of the early diagnosis of Rheumatoid Arthritis

目的抗环瓜氨酸肽抗体、类风湿因子(RF)三种分型IgGI、gA及IgM在早期类风湿关节炎诊断中的意义及应用价值。方法90例血清标本,包括32例早期类风湿关节炎,8例强直性脊柱炎,20例未确诊的早期关节炎,30例健康对照,以酶联免疫吸附法(ELISA)检测抗环瓜氨酸肽(CCP)抗体、类风湿因子(RF)-IgG、RF-IgA、RF-IgM,并随诊9个月。结果RA组抗CCP抗体、RF-IgG、RF-IgA、RF-IgM明显高于其余三组(p<0.05)。抗CCP抗体对RA诊断的特异性、敏感性、阳性预测值及阴性预测值均明显高于RF-IgG、RF-IgA、RF-IgM的相应指标。结论抗CCP抗体存在于RA疾病的早期,对早期RA有较好的敏感性和特异性,抗CCP抗体检测有利于RA的早期诊断。

Objective To assess the diagnosis significance of anti-CCP,RF-IgG,RF-IgA,RF-IgM in patients with early, Rheumatoid Arthritis （RA）.Methods Anti-CCP, RF-IgG,RF-IgA,RF-IgM were detected by ELISA in sere from 32 patients with early RA, 8 patients with Ankylosing Spondylitis （AS） ,20 patients with early arthritis,30 healthy blood donors.All of them were followed up for 9 months.Results The positive rate of anti-CCP,RF-IgG, RF-IgA mad RF-IgM in RA patients were significantly higher than that in other groups （p 〈 0.05）. Anti-CCP showed higher sensitivity, specificity, positive predictive value and negative predictive value than that of P,F-IgG, RF-IgA and RF-IgM. Conclusion Anti-CCP, presents in the early stage of RA, has a perfect value in diagnosis of early RA with better sensitivity and specificity.