抗GPI抗体和抗CCP抗体对RA诊断价值的比较分析

Comparative Analysis on the Diagnostic Value of Anti-Glucose-6-Phosphate Isomerase Antibodies and Anti-Cyclic Citrullinated Peptide Antibodies for Rheumatoid Arthrits

目的:评价抗环瓜氨酸肽(CCP)抗体和抗葡萄糖-6-磷酸异构酶(GPI)抗体对类风湿关节炎(RA)的诊断价值。方法:用酶联免疫吸附试验(ELISA)分别测定RA患者42例、其他风湿病患者32例以及健康对照者30例血清中的抗CCP抗体和抗GPI抗体,并应用R0C曲线比较两者对RA的诊断价值。结果:RA组血清抗CCP抗体水平(中位数)为283.0U/ml,与其他风湿病组(12.4U/ml)和健康对照组(11.2U/ml)比较,差异有统计学意义(P<0.01)。RA组血清GPI水平(1.68±1.50)mg/L明显高于其他风湿性疾病组(0.71±0.77)mg/L和健康对照组(0.43±0.24)mg/L差异也有统计学意义(P<0.01)。抗GPI抗体ROC曲线下面积为0.819,标准误0.046,其95%的近似可信区间为0.729～0.909。抗CCP抗体ROC曲线下面积为0.829,标准误为0.045,其95%的近似可信区间为0.741～0.916,两者均有较高的诊断价值。抗GPI抗体敏感性高于抗CCP抗体,但特异性比抗CCP抗体低。结论:抗GPI抗体同抗CCP抗体一样对RA有较高的诊断价值。

Objective To assess the diagnostic value of anti-cyclic citrullinated peptide antibodies and anti-glucose-6-phosphate isomerase antibodies for rheumatoid arthrits（RA）.Methods The levels of seurm anti-CCP and anti-GPI in 42 patients with RA,32patients with other rheumatic diseases and 30 normal controls were determined by ELISA.The diagnostic value of these two antibodies for RA were compared by receiver operating characteristic curve（ROC）.Results The median levels of anti-CCP were significantly higher in rheumatoid arthrits group（283.0U/ml）than those in other rheumatic diseases group（12.4U/ml）and healthy controls group（11.2U/ml）（P0.01）.The RA group serum anti GPI level（1.68±1.50mg/L）was slightly higher than that in other rheumatic diseases（0.71±0.77mg/L）and healthy controls（0.43±0.24mg/L）（P0.01）.According to receiver operating characteristic curve analysis,area under the curve of anti-GPIwas 0.819,standard error was 0.046,95%CI（0.729-0.909）;area under the curve of anti-CCP was 0.829,standard error was 0.045,95%CI（0.741-0.916）;the diagnostic value of them are similar.In RA the sensitivity of anti-GPI super to that of anti-CCP,but show lower specific than anti-CCP.Conclusion The level of anti-GPI have high value as same as anti-CCP in diagnosing RA.