联合检测抗CCP抗体、AKA与RF对类风湿性关节炎早期诊断的意义

Evaluation of anti-cyclic citrullinated peptide antibody、anti-keratin antibody and rheumatoid factor in diagnosis of early rheumatoid arthritis

目的:探讨联合检测抗环瓜氨酸肽抗体(anti-CCP)、抗角蛋白抗体(AKA)与类风湿因子(RF)对类风湿性关节炎(RA)早期诊断的意义。方法:采用酶联免疫吸附法(ELASA)检测anti-CCP,采用间接免疫荧光法检测AKA,采用速率散射比浊法检测RF。结果:RF、anti-CCP、AKA在RA组的阳性率分别为88.75%、86.25%、67.50%,在对照组的阳性率分别为39.22%、15.69%、25.49%,实验组均高于对照组(P<0.01)。三者对诊断RA的灵敏度和特异度分别为anti-CCP:86.25%,88.73%;AKA:67.5%,81.69%;RF:88.75%,71.83%。三者联合检测特异度可达94.37%,阳性预测值可达92.60%。结论:anti-CCP具有较好的灵敏度和特异度;联合检测anti-CCP、AKA与RF可明显提高对类风湿性关节炎早期诊断的特异性。

Objective： To explore the diagnostic significance of rheumatoid factor（RF） anti-keratin antibody（AKA） and anti-cyclic citrullinated peptide antibody（anti-CCP） in rheumatoid arthritis（RA） patients. Methods： RF,anti-CCP and AKA were detected by rate nephelometry method, ELISA and indirect immunofluorescence （IIF） respectively from 80 patients with RA and 71 with non-RA. Results： The positive rates of RF, anti-CCP and AKA in RA group （88.75%, 86.25%, 67.50%） were higher than those in control group （39.22%, 15.69%, 25.49%） （P〈0.01）. Especially, three of these autoantibodies can improve the specificity and the positive predictive value. Conclusion： Anti-CCP has relatively higher sensitivity and specificity in the diagnosis of early rheumatoid arthritis. The combined detection of anti-CCP, AKA and RF can improve the specificity of diagnosis of early RA.