抗体联合检测在类风湿关节炎早期诊断中的临床意义

The clinical value of combined detection antibodies in the early diagnosis of rheumatoid arthritis

目的探讨抗角蛋白抗体(AKA)、类风湿因子(RF)和抗环瓜氨酸肽抗体(抗-CCP抗体)联合检测在类风湿关节炎(RA)早期诊断中的临床意义。方法对RA患者68例,非RA其他风湿病患者90例同时检测AKA,RF和抗CCP抗体,AKA用间接免疫荧光法进行检测,RF和抗-CCP抗体用酶联免疫吸附法定量检测。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(69.1%)明显高于AKA(33.8%,P<0.01),与RF比较,差异无显著性(80.9%,P>0.05);抗CCP抗体和AKA特异性(94.4%,93.3%)较高,与RF比较,差异有显著性(74.4%,P<0.01);抗CCP抗体和RF联合检测敏感性达89.7%。结论RF敏感性较高,特异性较差;抗CCP抗体对RA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;抗CCP抗体和RF联合检测具有更高的敏感性。

Objective To explore the clinical significance of the combined detection of AKA, RG and anti-CCP antibody in the early diagnosis of rheumatoid arthritis（RA）. Methods AKA were detected by immunofluorescence technique, RF and anti-CCP antibody were measured by ELISA in 68 patients with RA and in 90 patients without RA. Results The positive rates of the three antibodies in RA group were significantly higher than of AKA（33. 8）（P〈0. 01） and it was no significant difference in comparison with RF. The specificity of anti-CCP（94. 4%） and AKA（93. 3%） were higher, there were significant difference in comparison with RF. The presence rare of the combinational test for both anti- CCP and RF was 89. 7%. Conclusion The combination testing of anti-CCP and RF has a higher sensitivity.