抗核周因子、抗角蛋白抗体、抗RA33抗体、抗环瓜氨酸肽抗体在类风湿关节炎诊断中的意义

Clinical significance on antiperinuclear factor,anti-keratin antibody,anti-RA33 and anti-cyclic citrullinated peptide antibody in the diagnosis of rheumatoid arthritis

目的检测抗核周因子(APF)在类风湿关节炎(RA)诊断中的意义,并比较APF、抗环瓜氨酸肽(CCP)抗体、抗角蛋白抗体(AKA)、抗RA33抗体、类风湿因子(RF)及5项联合检测在RA诊断中的意义。方法采用间接免疫荧光法检测APF、AKA,用ELISA法检测抗CCP抗体,抗RA33抗体及使用速率散射比浊定量法检测RF。共检测80例确诊RA患者和50例非RA其他自身免疫病患者及80例对照组,并结合临床资料进行分析。结果 APF、AKA、抗RA33抗体、抗CCP抗体和RF的灵敏度分别为61.3%、31.3%、28.8%、80.0%和77.5%,特异度分别为93.8%、93.8%、93.0%、97.7%和79.2%。RA患者5项阳性率均明显高于非RA患者(P<0.05)。联合检查中,RA阳性组APF+RF+CCP联合筛查阳性率已经达到95.0%。结论 4项指标在检测RA中同RF具有较高的敏感度和特异度,APF、抗CCP及RF联合筛查即可获得较高阳性率,选择自身抗体联用更有助于早期发现潜在RA患者。

Objective To evaluate the diagnostic value of antiperinuclear factor （APF）, anti-RA33, anti-keratin antibodies （AKA）,anti-cyclic citrullinated peptide（anti-CCP） antibody and rhenmatoid factor （RF） in patients and its joint detection with rheumatoid arthritis（RA）. Methods indirect immunofluorescent staining was used to assay APF and AKA,enzyme linked immu- nosorbent assays（ELISA） were used to detected anti-RA33 and anti-CCP,and RF was assay with rate nephelometry in 80 RA,in 50 patients with autoallergic disease except RA and 80 normal controls. Results The sensitivity of APF,AKA,anti-RA33,anti-CCP andRFwas 61.3%,31.3%,28.8%,80.0%and 77. 5%. while the specificity was 93.8%,93.8%,93.0%,97.7% and 79.2%. The positive rate of 5 indexes of RA patients were significantly higher than non RA patients （P〈0.05）. Conclusion The APF, AKA, anti-RA33,and antbCCP are serologic marker for RA as RF. Conclusion detection of the APF,RF and anti-CCP could have great clinic value in the diagnosis of RA.