第二代抗环瓜氨酸肽抗体的检测在类风湿关节炎诊断中的意义

The Clinical Value of Anti-Cyclic Citrullinated Peptide Antibody in Patients with Rheumatoid Arthritis

目的探讨抗环瓜氨酸肽(CCP)抗体的检测在类风湿关节炎(RA)诊断中的价值。方法ELISA法分别检测108例RA、89例非RA(其它风湿病患者)和78例健康体检者的抗CCP抗体;用间接免疫荧光法和速率散射比浊法检测抗角蛋白抗体(AKA)和类风湿因子(RF),分析CCP抗体的水平及与AKA、RF的相关性。结果抗CCP抗体的阳性率在RA中为87.4%(94/108),在非RA中为8.99%(8/89),正常人为0%(0/78)。3种抗体对RA诊断的敏感性和特异性分别为CCP87.4%、91.01%,AKA58.33%、82.24%,RF81.36%、75.35%。CCP抗体与AKA在RA患者血清中的阳性率之间差异非常显著,与RF差异不显著。3种方法的检测结果间存在相关性。结论用ELISA法检测血清中CCP抗体简便、结果可靠,对RA诊断具有高度的敏感性和特异性。

Objective To detect anti-cyclic citrullianted peptide（CCP）antibody in patients with rheumatoid arthritis（RA）and explore its clinical value. Methods Anti-CCP antibodies were examined by an EIASA in 108RA,89 non- RA patients and 78 normal donors. Anti-keratin antibodies （AKA） were detected by indirect immunofluorescence（IIF）. Rheumatoid factor（RF） was assayed by rate nephelometry method and compared the correlations among the anti CCP, AKA and RF. Resuits Among 108 patients with RA, 94 patients showed positive for anti-CCP（87.4%）, whereas only 8. 99 % in 89 non-RA patients. The sensitivity and specificity of anti-CCP antibodies, AKA and RF were 87.4%, 91.01%; 58. 33%,82. 24%; 81.14%,79.47% in RA respectively. Anti-CCP antibodies are more sensitive and specific than RF and AKA for diagnosing RA, although there were correlations among three kinds of antibodies. Conclusion Detecting anti-CCP antibodies by EI.ISA may be a brief, standard and reliable method. Anti-CCP antibodies can be considered as one kind of masker antibody for RA.