抗瓜氨酸肽抗体在类风湿性关节炎中的诊断价值

Diagnostic value of anti-citrullinated peptide antibodies in rheumatoid arthritis

目的:探讨抗瓜氨酸肽抗体(CCP)在类风湿关节炎(RA)诊断中的临床应用价值。方法:检测类风湿性关节炎(RA)患者组、其他结缔组织疾病(CTD)组和健康体检者组中血清中抗CCP抗体和RF水平,观察抗CCP抗体在各组中的诊断灵敏度、特异度、阳性预测值和阴性预测值。结果:RA组的抗CCP抗体阳性率明显高于正常对照组,差异有统计学意义(P<0.05);抗CCP抗体的灵敏度、特异度、阳性预测值、阴性预测值:75%、94.8%、91.6%、87.4%;RF为85.8%、54.3%、60.8%、87.9%。结论:抗CCP抗体在诊断RA的灵敏度低于RF,但特异性高于RF,两者联合检测特提高RA诊断和与其他结缔组织病的鉴别诊断。

Objective：To assess the diagnostic value of anti-cyclic citrullinated peptide antibodies in rheumatoid arthritis（RA）. Methods： Anti-cyclic citrullinated peptide（anti-CCP）antibodies and rheumatoid factor（RF）were determined in RA,CTD and healthy group, respectively. Sensitivity,specificity,positive and negative predictive value for anti-CCP antibodies in those group were assessed. Results： Positive rate of anti-CCP antibodies in RA group was more higher than that in control group in which significant statistical difference was observed （P〈0.05）. Sensitivity,specificity,positive and negative predictive value for anti-CCP antibodies were respectively 75%,94.8%, 91.6%,87.4%,and for RF were respectively 85.8%,54.3%,60.8%,87.9%. Conclusion： Anti-CCP antibodies detection is less sentitive than RF in diagnosis of RA,but more specific. Two methods could be used simultaneouly for improving diagnosis of RA and differential diagnosis between RA and CTD.