抗瓜氨酸化蛋白/肽抗体和RF联合检测对类风湿关节炎的诊断价值

Diagnostic value of anti-citrullinated protein/ peptide autoantibodies and rheumatoid factor in rheumatoid arthritis

目的:探讨三种抗瓜氨酸化蛋白/肽抗体(ACPA)与RF对RA的诊断意义及其联合检测的诊断价值。方法:对149例RA2、19例其他风湿性疾病患者和96名健康对照者的血清进行ACPA和RF检测。RF采用免疫比浊法检测,抗CCP(Ⅱ)抗体采用酶联免疫吸附法检测,抗角蛋白抗体(AKA)和抗核周因子抗体(APF)采用间接免疫荧光法检测。结果:抗CCP(Ⅱ)抗体、AKA、APF、RF对RA诊断敏感性分别为68.5%、30.2%5、2.4%、70.5%,特异性分别为94.5%、96.8%、95.9%、79.9%,RF对RA诊断价值不如ACPA。结论:抗CCP(Ⅱ)抗体是诊断RA最为重要的实验室指标,三项ACPA联合检测几乎不能增加诊断敏感性,但其特异性是最好的(100%)。

Objective：To explore the diagnostic value and relationship of anti-citrullinated protein/peptide autoantibodies（ACPA）and rheumatoid factor（RF） in rheumatoid arthritis（RA）.Methods： 149 RA patients,219 cases with other rheumatic diseases,and 96 healthy subjects were enrolled.Rheumatoid factor（RF） was measured by the immunonephelometry method;Anti-CCP（Ⅱ） antibodies were measured by enzyme linked immunosorbent assay（ELISA） test;AKA and APF were detected by indirect immunofluorescence test.Results： The sensitivities of anti-CCP（Ⅱ） antibody,AKA,APF and RF for RA were 68.5%,30.2%,52.4%,70.5% respectively,while the specificities were 94.5%,96.8%,95.9%,79.9%.The diagnostic value of RF was less than ACPA for RA.Conclusion： Anti-CCP（Ⅱ） antibody was the most valuable marker in the diagnosis of RA.Combined detection of anti-CCP（Ⅱ）,AKA and APF did not increase the diagnostic capability for RA,but it had the highest specificity（100%）.