抗环瓜氨酸肽抗体联合类风湿因子检测对类风湿性关节炎诊断的临床价值

The Clinical Value of Anti-Cyclic Citrullinated Peptide Antibody and Rheumatoid Factor Combined Detection in Rheumatoid Arthritis

目的探讨联合检测抗环瓜氨酸肽抗体(anti-CCP)与类风湿因子(RF)对类风湿关节炎(RA)早期诊断的意义。方法选取2008年1月—2009年1月收治确诊RA患者中随机抽取100人作为RA组,以健康人50例作为对照组,采用酶联免疫吸附法(ELISA)检测抗CCP抗体,采用速率散射比浊法检测RF。结果RA组的anti-CCP阳性率为67%,RF的阳性率为78%。对比分析发现RA患者血清中的anti-CCP对RA诊断的灵敏度比RF的灵敏度低,差异具有显著性(P<0.05);而anti-CCP的96.0%的特异性比RF的88.0%要高,差异具有显著性(P<0.05)。两者联合检测灵敏度可提高,特异性可达100.0%。结论RF与anti-CCP联合使用可进一步提高RA诊断的灵敏度和特异性,有利于对RA的早期检出。

Objective To investigate the significance of the combined detection of anti-cyclic citrullinated peptide（CCP） antibody and rheumatoid factor（RF） in the early diagnosis of rheumatoid arthritis（RA）.Methods 100 patients diagnosed with RA were randomly selected,who were admitted to hospital from 2008 to 2009,and 50 cases of healthy people as control group,Anti-cyclic citrullinated peptide（CCP） antibody was detected by enzyme-linked immunosorbent assay（ELISA）,and RF was detected by rate nephelometry method.Results In RA group,the anti-CCP antibody positive rate was 67%,while RF-positive rate was 78%.Comparative analysis showed that the anti-CCP antibody had lower sensitivity than RF in diagnosis of RA,the difference was significant（P〈0.05）.But the anti-CCP antibodies had higher specificity with 96.0% than the RF with 88.0%,the difference was also significant（P〈0.05）.Sensitivity can be increased and specificity can be event increased to 100% when combining the two detections.Conclusion RF and anti-CCP antibody in combination can further improve the sensitivity and specificity of RA diagnosis,which is beneficial for the early diagnosis of RA.