类风湿关节炎六种指标联合检测的临床意义

Clinical Values of Combined Detection of Six Markers in Patients with Rheumatoid Arthritis

目的评价分析抗瓜氨酸化波形蛋白(MCV)抗体、抗葡萄糖-6-磷酸异构酶(GPI)抗体等六项指标在类风湿关节炎(RA)患者血清中的表达与疾病的相关性及应用价值。方法收集110例RA、26例SLE、23例强直性脊柱炎(OA)、20例干燥综合征(SS)患者和50名健康人血清标本,用ELISA检测血清中抗MCV、抗GPI和抗环瓜氨酸肽(CCP)抗体水平,采用间接免疫荧光法检测抗角蛋白(AKA)抗体,采用散射比浊法检测类风湿因子(RF)和hs-CRP水平。结果 4种抗体在RA患者组中的阳性率显著高于非RA疾病组和健康对照组。除AKA抗体阳性率较低(41.8%)外,其余抗体在RA组中的阳性率差异无统计学意义。结论抗MCV和抗GPI抗体诊断RA的敏感度最高;抗CCP抗体的特异性最高,AKA抗体具有较高的特异性,但敏感度最低,联合检测可弥补单项抗体检测造成的漏诊。

Objective To investigate the serum levels of 4 auto-antibodies including MCV, GPI and other markers in patients with rheumatoid arthritis （RA） and to assess their clinical application values. Methods The four auto-antibodies including MCV, GPI, CCP, AKA and RF and hs-CRP were detected in serum samples of 110 patients with RA, 26 patient with SLE, 23 patients with OA, 20patients with SS, and 50 healthy controls. Results The positive rates of these four auto-antibodies in RA patien patient groups and health controls. Except anti-AKA, there was no ts were significantly higher than in other significantly differences in the levels of other antibodies among these groups. Conclusion Anti-MCV and anti-GPI has the highest sensitiwty m the di- agnosis of RA, while anti-CCP has the highest specificity and anti-AKA have good specificity with lowest sensitivity. The combination detection of these auto-antibodies could decrease the missed diagnosis by single test.