多种自身抗体联合检测在类风湿性关节炎诊断中的应用

Application of combined detection of autoantibodies in diagnosis of rheumatoid arthritis patients

目的:探讨多种自身抗体联合检测在类风湿性关节炎(RA)早期诊断中的意义.方法:采用散射比浊法检测类风湿因子(RF);间接免疫荧光法检测抗核抗体(ANA),抗角蛋白抗体(AKA);ELISA法检测抗Sa抗体,抗环瓜氨酸肽抗体(抗-CCP抗体);斑点法检测抗聚角蛋白微丝蛋白抗体(AFA).结果:各组自身抗体检测的阳性率比较,抗AKA抗体,RF和抗-CCP抗体的阳性率较高,分别为46.8%,45.8%和61.4%,为多种自身抗体联合检测中的最佳实验;RF,抗-CCP抗体,抗AKA抗体三种抗体联合检测RA,为较好的组合项目,在RA检测中有较高的应用价值.结论:选择适当的自身抗体指标联合检测有助于提高RA检测的阳性率.

AIM： To research the diagnostic significance of many autoantibodies in the patients with early rheumatoid arthritis （RA）. METHODS ： Rheumatoid factor （RF） was examined by scattering turbidimetric method ; Anti-nuclear antibodies （ANA） and antikeratin antibodies（AKA） were detected by fluoroimmunoassay; Anti-Sa antibodies and anti-cyclic citrullinated peptide （CCP） antibodies were detected by ELISA; antifilaggrin antibody （AFA） was detected by spotting method. RESULTS： Higher than those of the other autoantibodies, the positive rates of AKA, RF and anti-CCP were 46.8%, 45.8% and 61.4%, respectively. These three autoantibodies were the best indicators in all. The detection of RF combined with the detection of higher sensitive CCP antibodies and antikeratin antibodies improved the detection rate and specificities of RA and had the high application value in the diagnosis of the elders with early RA. CONCLUSION： The combined detection of the proper autoantibodies can improve the positive rate of RA detection.