摘要
目的:探讨抗环瓜氨酸肽抗体(anti-CCP)、类风湿因子IgM(IgM-RF)联合检测在类风湿关节炎(RA)早期诊断中的价值。方法:用ELISA法对84例RA、96例非RA和26例健康献血者中anti-CCP抗体及IgM-RF进行检测;分析anti-CCP抗体、IgM-RF及两者联合检测的敏感度、特异度、阳性似然比、阴性似然比。结果:RA患者anti-CCP抗体的含量约为15.73±3.35Ru/ml;IgM-RF约为79.93±33.83Ru/mL,均显著高于非RA组和健康对照组(P〈0.01)。anti-CCP抗体及IgM-RF对诊断RA的敏感度、特异度、阳性似然比、阴性似然比分别为:anti-CCP抗体(67.9%、94.8%、13.02、0.34),IgM-RF(71.4%、79.2%、3.43、0.36)。anti-CCP抗体与IgM-RF联合检测敏感度和特异度分别为65.5%、96.9%,阳性似然比、阴性似然比分别为21.13、0.36。提示anti-CCP抗体的特异度、阳性似然比明显高于IgM-RF,IgM-RF较anti-CCP抗体有较高的敏感度,两者联合检测可提高诊断的特异度和阳性似然比,但不能提高敏感度。结论:anti-CCP抗体和IgM-RF联合检测可提高诊断的特异度和阳性似然比,对RA的早期诊断有较好的临床价值。
Objective To evaluate the clinical value of combined detection of anti-cyclic citrullinated peptide antibody and rheumatoid factor IgM-RF in rheumatoid arthritis (RA) early diagnosis. Methods 84 patients with established RA, 96 patients without RA and 26 healthy blood donors were enrolled in the investigation. Serum anti-CCP antibody and IgM-RF were detected by applying enzyme- linked immunosorbent assay (ELISA), and the results of anti-CCP antibody and IgM-RF were compared for sensitivity, specificity, positive likelihood radio (+LR) and negative likelihood radio (-LR). Meanwhile, combined detection results of anti-CCP antibody and IgM-RF was also analyzed. Results The serum level of anti-CCP antibody and IgM-RF in RA group was (15. 73 ± 3. 35) RU/ml and (79. 934±33.83) RU/ml, were obviously higher than that in non-RA group and healthy control group respectively. The sensitivity, specificity, +LR and -LR of anti-CCP antibody in diagnosing RA was 67.9%, 94.8%, 13.02 and 0.34 respectively, and the corresponding item of IgM-RF was 71.4%, 79.2M, 3. 43 and 0. 36 respectively, the combined detection of anti-CCP antibody and IgM-RF 65.5M ,96.9%, 21.13 and 0. 36 in sequence. It suggested that the specificity and q-LR of anti-CCP antibody were obviously higher than those of IgM-RF; but the sensitivity of IgM-RF was higher than that of anti-CCP antibody. The combined detection of anti-CCP antibody and IgM-RF might increase the specificity and +LR, but not in the sensitivity. Conclusion Anti-CCP antibody has a higher speci- ficity (94.8M) than IgM-RF (79. 2%) for RA. The combined detection of anti-CCP antibody and IgM-RF may further increase the specificity and +LR, and it has a higher clinical value in RA early diagnosis.
出处
《国际检验医学杂志》
CAS
2007年第8期696-698,共3页
International Journal of Laboratory Medicine
关键词
类风湿性关节炎
抗环瓜氨酸肽抗体
类风湿因子
Rheumatoid arthritis (RA)
Anti-cyclic citrullinated peptide antibody
Rheumatoid factor (IgM-RF)