3种抗体联合检测在类风湿关节炎诊断中的应用

Application of combined detection of anti-MCV,anti-ACF and anti-RA33 in the diagnosis of rheumatoid arthritis

目的探讨抗突变型瓜氨酸波形蛋白(抗-MCV)抗体、抗瓜氨酸化纤维蛋白原抗体(ACF)、抗-RA33联合检测在类风湿关节炎(RA)中的临床应用价值。方法对96例RA患者和50例其他自身免疫疾病患者及50名健康对照者采用酶联免疫吸附试验(ELISA)检测抗-MCV、抗-ACF、抗-RA33,观察各指标及3项联合检测对RA的诊断价值。结果单指标检测抗-MCV对RA的敏感性为84.37%(81/96),特异性为95.00%(95/100);抗-ACF对RA的敏感性为64.58%(62/96),特异性为93.00%(93/100);抗-RA33对RA的敏感性为13.54%(13/96),特异性为98.00%(98/100)。3项指标中任一指标阳性即作为阳性的敏感性最高(95.22%);而3项指标均为阳性才视为阳性的敏感性略低于抗-ACF,但特异性可达99.00%。结论抗-MCV、抗-ACF、抗-RA33是RA较为特异的指标,3项指标联合检测可以把阳性患者的误诊率降到最低,有助于对RA的早期诊断、治疗和病情预后估计。

Objective To investigate the application value of combined detection of anti-mutant citrullinated vimentin（anti-MCV）,anti-citrullinated fibrinogen（ACF）and anti-RA33in rheumatoid arthritis（RA）.Methods 96 RA patients,50patients with other autoimmune diseases and 50healthy controls were enrolled and detected for the three indicators by using enzyme-linked immunosorbent assay（ELISA）,and the diagnosis value of single and combined detection was evaluated.Results For single detection,the diagnostic sensitivity and specificity of anti-MCV for RA were 84.37%（81/96）and 95.00%（95/100）,of ACF were 64.58%（62/96）and 93.00%（93/100）,of antiRA33were 13.54%（13/96）and 98.00%（98/100）.Taking positive results of any of the three indicator as the criterion for positive results of combined detection,the diagnostic sensitivity was the highest（95.22%）,and taking positive results of all of the three indicators as the criterion,the sensitivity was lower than ACF,but the specificity could reach 99.00%.Conclusion anti-MCV,ACF and anti-RA33could be specific indicator of RA,and combined detection of the three indicators could minimize the misdiagnosis rate in patients with positive results and contribute to the early diagnosis,treatment and prognostic estimation of RA.