抗环瓜氨酸多肽抗体、RF在类风湿关节炎诊断中的应用评价

Evaluation of Anti-cyclic Citrullinated Peptide Antibody and Rheumatoid Factor in the Diagnosis of Rheumatoid Arthritis

目的 探讨抗环瓜氨酸多肽（anti-CCP）抗体、类风湿因子（RF）在类风湿关节炎（RA）诊断中的意义.方法 通过检测126份RA患者,44份其他自身免疫性疾病患者和30份体检者血清的anti-CCP抗体和RF,分析其在RA诊断中的价值.结果 RA组anti-CCP抗体和RF水平显著高于非RA组和健康对照组（P＜0.01）,非RA组和健康对照组之间anti-CCP抗体差异无统计学意义.单独测定anti-CCP,RF,对RA检出的敏感度分别为57.1%,62.7%,特异度为95.9%,78.4%,二者敏感度差异无统计学意义（P＞0.05）,特异度差异有统计学意义（P＜0.01）,ROC曲线面积分别为0.826 0,0.733.联合检测抗CCP抗体和RF敏感度和特异度分别为80.16%,98.65%,anti-CCP抗体与RF呈正相关.结论 anti-CCP抗体对RA具有较好的敏感度和很高的特异度,作为RA早期诊断的血清学指标,anti-CCP抗体优于RF.二者联合检测对于提高早期RA筛查的 敏感度和诊断的特异度,以及RA的预后判断、治疗观察有重要意义.

Objective To investigate the significance of anti-cyclic citrullinated peptide （anti-CCP） antibody and rheumatoid factor（RF） in the diagnosis of rheumatoid arthritis. Methods Anti-CCP antibody and RF were tested in 200 patients（including 126 patients,44 patients with other autoimmune diseases and 30 healthy controls）,analyze the diagnostic value in RA. Results The levels of anti-CCP antibody and RF in RA group were significantly higher than non-RA group and the healthy control group （P〈0.01）,non-RA group and the healthy control group showed no significant difference with the level of anti-CCP antibody. Determined anti-CCP antibody,RF separately,the sensitivity for RA were 57.1% and 62.7%, specificity were 95.9% and 78.4% ,no significant differences between the two sensitivity （P〉0. 05）,specific differences P 〈0. 01 ,ROC curve area were 0. 826 0 and 0. 733 respectively. The sensitivity and specificity were 80.16% and 99.4% with combined detection of anti-CCP antibody and RF,the levels of RF were positively correlated with anti-CCP. Conclusion Anti-CCP antibody in RA has good sensitivity and high specificity,as serological markers for early RA diagnosis,anti-CCP antibody was prior to RF. Combined detection of both will improve the screening sensitivity and specificity in early RA diagnosis and is important for the prognosis and treatment observation in RA.