抗环瓜氨酸肽抗体和血管内皮生长因子对类风湿关节炎实验诊断意义探讨

The value of anti-cyclic citrullinated peptide antibody and vascular endothelial growth factor in the diagnosis of rheumatoid arthritis

目的探讨抗环瓜氨酸肽(CCP)抗体和血管内皮生长因子(VEGF)在类风湿关节炎(RA)诊断中的意义以及与类风湿因子(RF)的相关性。方法采用酶联免疫吸附试验(ELISA)分别检测实验组和对照组抗CCP抗体和VEGF,采用速率散射光比浊法检测RF水平,并分析上述三者之间的关系。其中实验组为48例RA患者,对照组为32名健康人。结果抗CCP抗体特异性、敏感性、阳性预测值和阴性预测值依次为100.0%、85.4%、100.0%、82.1%;VEGF的特异性、敏感性、阳性预测值和阴性预测值依次为56.3%、97.9%、77.0%、94.7%;RF特异性、敏感性、阳性预测值和阴性预测值依次为100.0%、89.6%、100.0%、86.5%。三者之间两两具有相关性,尤以VEGF和抗CCP抗体相关性为好。结论抗CCP抗体和VEGF在RA诊断中具有其独特的应用价值。抗CCP抗体特异性与RF相同并优于VEGF,VEGF敏感性最高,而三者联合检测可进一步提高试验诊断特异性和敏感性。

Objective To evaluate the value of anti-cyclic citrullinated peptide （CCP） antibody and vascular endothelial growth factor （VEGF） in the diagnosis of rheumatoid arthritis （RA）. And to investigate whether they were related with rheumatoid factor （RF）. Methods The level of VEGF and anti-CCP antibody,in 48 patients with RA and in 32 healthy cases was detected by enzyme-linked immunosorbent assay （ELISA）. RF was detected by nephelometry and the correlation among them was analysed. Results The specificity, sensitivity, positive predictive value and negative predictive value of anti-CCP antibody were 100.0% ,85.4%, 100.0% ,82.1% ;those of VEGF were 56.3% ,97.9%, 77.0% ,94.7% ;and those of RF were 100.0% ,89.6%, 100.0% ,86.5%. There was a correlation among them, especially between VEGF and anti-CCP antibody. Conclusions Anti-CCP and VEGF have unique value in the diagnosis of RA. The specificity of anti-CCP and RF are best;The sensitivity of VEGF is best,and the combination detection of them can improve the diagnostic value in RA.