抗环瓜氨酸肽抗体及相关自身抗体对类风湿关节炎诊断的应用评价

Application of anti-cyclic citrullinated peptides and related auto-antibodies in diagnosing rheumatoid arthritis

目的探讨抗环瓜氨酸肽(cyclic citrullinated peptides,CCP)抗体及相关自身抗体在类风湿关节炎(rheumatoid ar-thritis,RA)诊断中的意义。方法采用ELISA法检测抗CCP抗体,间接免疫荧光法检测抗角蛋白抗体(antikeratin antibody,AKA)、抗核抗体(antinuclear,antibody,ANA),类风湿因子(rheumatoid factor,RF)用免疫比浊法检测。共检测血清标本320例,其中RA患者及非RA患者均为120例,80例健康对照血清。结果抗-CCP、AKA、ANA和RF对诊断RA的敏感性分别为73.33%、51.67%、78.30%、87.50%。抗-CCP的敏感性显著高于AKA(P<0.05),分别低于ANA和RF,但未达到统计学水平。4个指标的特异性为97.50%、96.67%、36.70%和22.50%。抗CCP特异性与AKA相当,但显著高于ANA和RF(P<0.05)。结论抗CCP诊断RA敏感性好特异性高,有很好的临床应用价值。抗CCP和抗AKA为RA特异性诊断指标,联合检测有利于提高临床对RA的早期诊断。

Objective To explore the significance of anti-cyclic citrullinated peptide antibody （anti-CCP）,anti-keratin antibody （AKA） ,antinuclear autoantibody （ANA） and rheumatoid factor （RF） in the diagnosing rheumatoid arthritis （RA）. Methods Anti-CCP,AKA （ANA） and RF in 120 patients with RA and in 120 patients without RA and in 80 normal controls were measured by ELISA,indirect immune fluorescence and the rate scatting immunity method. Results The sensitivity of anti-CCP, AKA, ANA and RF in the diagnosing of RA was 73. 33%, 51. 67%, 78. 30% and 87. 50%, respectively. The specificity was 97. 50 %,96.67%, 36.70% and 22.50% ,respectively. The sensitivity of anti-CCP was Significantly higher than that of AKA （P〈0.05） ,and a little lower than that of ANA and RF. AS to the specificity,there was no statistical difference between anti-CCP and AKA, while the specificity of anti-CCP was significant higher than that of ANA and RF（P〈0. 05）. Conclusion The anti-CCP presents a good sensitivity and specificity in the diagnosis of RA.