AKA、APF及抗CCP联合检测与类风湿关节炎的早期诊断

To exam the anti-cyclic citrullinated peptide antibody,anti-keratin antibody and antiperinuclear factor and to evaluate the diagnosis method of the early patients with rheumatoid arthritis

目的联合检测类风湿关节炎(RA)患者血清中的抗环瓜氨酸抗体(CCP)和抗角蛋白抗体(AKA)、抗核周因子抗体(APF),探讨RA的早期诊断方法。方法对已确诊的71例RA患者、207例非RA的自身免疫病患者同时测定抗CCP抗体(ELISA法)和AKA、APF(间接免疫荧光法)。结果AKA、APF及抗CCP抗体对早期RA的敏感性分别为46.5%、77.5%和69.0%;特异性分别为100%、100%和98.8%。CCP及APF的阳性检出率高于AKA(p<0.01)而与类风湿因子(RF)无差异(p=0.067).RF弱阳性或阴性的RA患者,AKA、APF及CCP可为阳性。结论CCP抗体及APF对RA具有较好的敏感性和高度的特异性,联合检测AKA、APF、CCP抗体可作为早期RA病人及RF阴性RA病人的早期诊断指标。

Objective To exam the anti-cyclic citrullinated peptide antibody(CCP),anti-keratin antibody(AKA) and antiperinuclear factor(APF) and to evaluate the diagnosis method of the rheumatoid arthritis(RA).Methods Serum level of CCP,AKA and APF were examed simuitancously by ELISA and indirect immunofluorescence(IIF) respectively in 71 RA and 207 non-RA patients.Results In RA patients,the sensitivity of anti-CCP,AKA and APF were 46.5%,77.5% and 69.0% while the specificity were 100%,100% and 98.8% respectively.As for sensitivity,there was a significant difference between the methods of anti-CCP,APF And AKA assay.However,no difference was found between anti-CCP,APF And RF assay.The AKA,APF and anti-CCP can be positive in the RF positive RA patients and the negative RA patients.Conclusion Anti-CCP and APF is quite sensitive and specific in the diagnosis of RA.To exam the anti-CCP,AKA and APF may be useful factors for early positive or negative RA patients.