抗环瓜氨酸肽抗体检测在类风湿关节炎中的临床意义

Clinical significance of anti-cyclic citrullinated peptide antibody in patients with rheumatoid arthritis

目的研究抗环瓜氨酸肽抗体（抗CCP抗体）的检测在类风湿关节炎（RA）诊疗中的临床价值。方法检测45例RA患者、22例其他疾病患者和20例正常体检者血清中的抗CCP抗体和类风湿因子（RF）。抗CCP抗体用酶联免疫吸附试验（ELISA）检测，RF用免疫散射比浊法检测。结果45例RA患者中，抗-CCP抗体阳性率为62．2％（28／45），其他疾病的阳性率为4．5％（1／22），正常体检者都为阴性。抗-CCP抗体对RA诊断的灵敏度为62．2％，特异度为97．6％。联合检测抗CCP抗体和RF可提高RA诊断的灵敏度（86.7％）。结论抗-CCP抗体对RA诊断具有良好的灵敏度和特异性，可视为RA特异的血清学指标。联合检测抗CCP抗体和RF有助于RA的早期诊断和预测病情的进展。

Objective To study the clinical value of measurement of serum anti-cyclic citrullinated peptile antibody （anti-CCP Ab） in patients with rhematoid arthritis （RA）. Methods Serum anti-CCP Ab and RF contents were measured in 45 patients with rhematoid arthritis （RA）, 22 patients with other disease and 20 healthy people. Anti-CCP Ab was detected by ELISA, and RF was detected by scattering immunoturbidimetric assay. Results The positive rate of anti-CCP Ab was 62. 2% （28/15） in patients with RA, 45% （1/22） in patients with other disease, and 0% in healthy people. The diagnostic sensitivity of anti-CCP was 62. 2%, and the diagnostic specificity was 97. 6% for RA. The diagnostic sensitivity of anti-CCP combined with RF was 86. 7% for RA. Conclusions Anti-CCP has good specificity and diagnostic sensitivity for rheumatoid arthritis. Anti-CCP can be regarded as a specific serum marker for RA. Combined detection of serum anti-CCP Ab and RF may be helpful for early diagnosis of rheumatoid arthritis.