抗环瓜氨酸肽抗体、类风湿因子和白介素-17对类风湿关节炎的诊断意义

Clinical value of serum anti-CCP antibody,RF and IL-17 levels in patients with rheumatoid arthritis

目的:研究类风湿关节炎(rheumatoid arthritis,RA)患者血清抗环瓜氨酸肽(cyclic citrullinated peptide,CCP)抗体、类风湿因子(rheumatoid factor,RF)和白介素-17(interleukin-17,IL-17)水平变化及临床应用价值。方法:收集80例RA患者血清,以80例健康体检者血清作对照。采用双抗体夹心酶联免疫吸附法测定血清抗CCP抗体,IL-17含量,特种蛋白仪检测RF含量,并进行统计分析。结果:RA患者活动期上述指标的含量均显著高于稳定期和健康对照组(P<0.01)。RA患者组三项指标的阳性率明显高于正常对照组(P<0.01)。RF诊断RA的敏感性高于抗CCP抗体及IL-17,而抗CCP抗体对RA的特异性显著高于RF及IL-17。两两联合检测及三者联合检测敏感性较单独检测都有所减低,而特异性增高明显,三者联合检测,特异性达到100%。结论:动态监测抗CCP抗体、RF和IL-17有助于观察RA病情变化,提高RA诊断率。

Objective： To explore the clinical significance and the clinical value of changes of serum anti-CCP antibody, rheumatoid factor （RF） and IL-17 levels in patients with rheumatoid arthritis （RA）. Methods ： Serum anti-CCP antibody and IL-17 was detected in 80 case of RA and 80 case of healthy physical examines by enzyme linked immunosorbent assay（ELISA） , Beckman automated protein analysis system was used to detect serum RF. Following, some statistical analysis for these data were done. Results： Anti- CCP antibody, RF and IL-17 levels in the acute phase of RA group were significantly higher than those in the stable phase of RA group and the healthy physical examines group （P 〈 0. 01 ）. Three detection items positive rate were apparently higher in RA group than in the healthy physical examines group （P 〈0. 01 ）. Comparative analysis showed that RF sensitivity was higher than anti-CCP antibody and IL-17. But the anti- CCP antibodies had higher specificity than RF and IL-17. Sensitivity can be decreased when combining two or three detection items, but specificity can be event increased to 100% when combining three detection items. Conclusions： Not only monitoring the serum levels of anti-CCP antibody, RF or IL-17 was helpful for observation the development of rheumatoid arthritis, but also can improve diagnosis.