血清抗环瓜氨酸肽抗体和葡萄糖-6-磷酸异构酶对类风湿关节炎的诊断价值

The Diagnostic Value of Anti-cyclic Citrullinated Peptide Antibodies and Glucose-6-Phospated Isomerase in Patients of Rheumatoid Arthritis

目的:评价抗环瓜氨酸肽抗体(抗-CCP)及葡萄糖-6-磷酸异构酶(GPI)对类风湿关节炎(rheumatoid arthritis,RA)的诊断价值。方法:用酶联免疫吸附试验(ELISA)方法检测136例RA患者、246例非RA的风湿病患者和31例健康对照者的血清抗-CCP和GPI浓度,根据受试者工作特征曲线(ROC)比较抗-CCP和GPI的曲线下面积,比较两者对RA的诊断价值。结果:以试剂盒制定的5U.L-3和0.20μg.L-3为抗-CCP和GPI的诊断临界值,诊断RA的敏感度和特异度:抗-CCP分别为90.4%和93.5%、GPI分别为35.3%和87.7%,抗-CCP和GPI的ROC曲线下面积分别为0.958和0.685。结论:抗-CCP对RA的诊断价值优于GPI。在检测抗-CCP的同时加测GPI,与抗-CCP独立试验比较,联合试验可提高特异度6%,平行试验可提高敏感度约1%。

Objective：To assess the diagnostic value of anti-cyclic citrullinated peptide antibodies（anti-CCP） and glucose-6-phospated isomerase（GPI） for rheumatiod arthritis（RA）.Methods： The levels of anti-CCP and GPI were detected in serum samples of 136 RA patients,246 non-RA patients with various rheumatic diseases and 31 normal controls by enzyme-linked immunosorbent assay（ELISA）.The diagnostic value of anti-CCP and GPI were compared with Chi-square test and receiver operator characteristic curve（ROC）.Results： The critical value of anti-CCP and GPI were 5 U·L-3and 0.20 μg·L-3,then the sensitivities for anti-CCP and GPI were 90.4% and 35.3%,and the specificities were 93.5% and 87.7%.The area under the curve of anti-CCP and GPI were 0.958 and 0.685.Conclusions： The diagnostic value of anti-CCP is better than GPI.If we combine anti-CCP and GPI,we can increase 6% in specificity（for combination experiment） and 1% in sensitivity（for parallel experiment）.