抗CCP抗体、AKA和RF联合检测在类风湿关节炎诊断中的价值

The Clinical Value of the Combination of Anti-cyclic Citrullinated Peptide Antibody,Anti-keratin and Rheumatoid Factor in Patients with Rheumatoid Arthritis

目的探讨抗环瓜氨酸肽抗体(抗CCP抗体)、抗角蛋白抗体(AKA)和类风湿因子(RF)联合检测在类风湿关节炎诊断中的临床意义及价值。方法分别采用酶联免疫吸附实验、间接免疫荧光法、免疫散射浊度法和魏氏法检测93例RA患者和54例非RA患者血清中抗CCP抗体、AKA、RF、免疫球蛋白、补体、CRP和ESR,血常规采用LH750全血细胞分析仪分析。结果RA组患者抗CCP抗体阳性率高于非RA组患者,差异有统计学意义(P<0.05)。RA组中抗CCP抗体、AKA和RF三者敏感性、特异性分别为76.3%、63.4%、79.6%;92.6%、100%7、7.8%。抗CCP抗体阳性和阴性患者在RF滴度值、ESR和晨僵方面存在统计学意义(P<0.05)。结论抗CCP抗体具有较高的敏感性和特异性,可作为诊断RA的一项特异性的血清学指标,抗CCP抗体在一定程度上可能有助于病情判断和活动性的监测,抗CCP抗体、AKA和RF三者联合检测具有较高的特异性,可提高RA的检出率。

Objective To evaluate the significance of the combination of anti-cyclic citndlinated peptide antibody （anti-CCP）, anti-keratin（AKA） and rheumatoid factor（RF） in patients with rheumatoid arthritis （RA）. Methods In 93 case with RA and 54 ease without RA , anti-CCP , AKA and RF were detected by enzyme linked immunosorbent assay, indirected immunfluorescence and the rate scatting immunity method respectively. Results The positive rate of anti-CCP in RA patients was higher than that in patients without RA（P 〈 0.05）.The sensitivity of anti-CCP ,AKA and RF were 76.3% ,63.4% and 79.6% respectively,while the specificity were 92.6% , 100% and 77.8 % respectively . There were correlation between them. morning stiffness, ESR and making fists in RA patients with anti-CCP postive or negative had significant difference（ P 〈 0.05）. Conclusion Anti-CCP antibody was quite sensitive and specific in diagnosing RA and it may be a useful index for diagnosing RA. What is more, The combination of anti-CCP ,AKA and RF will play an important role in improving detective rate of RA.