抗环瓜氨酸肽抗体在幼年特发性关节炎中的诊断意义

Significance of anti-cyclic citrullinated antibodies in Juvenile Idiopathic arthritis

目的探讨抗环瓜氨酸肽(anti-cyclic citrullinated petide)抗体、抗角蛋白抗体(anti-keratin antibody,AKA)和抗核周因子抗体(antiperinuclear factor,APF)联合检测在诊断幼年特发性关节炎中的价值。方法对61例JIA患儿与40例健康患儿进行3项检测,并进行比较分析。结果幼年特发性关节炎(juvenile idiopathic arthritis,JIA)患儿的3项检测指标阳性率均明显高于正常健康患儿,差异有统计学意义(P<0.01),在JIA组患儿中抗CCP、AKA、APF的敏感性分别为55.73%、39.34%、26.23%,抗CCP抗体的敏感性高于AKA和APF,差异有统计学意义(P<0.05)。结论抗CCP抗体在JIA患儿中的敏感性虽不及成人类风湿性关节炎(rheumatoid arthritis,RA),但对JIA的诊断仍具有较高的敏感性和特异性,特别是对多关节型和少关节型JIA的诊断更有价值。

Objective To investigate the anti-cyclic citrullinated peptide（anti-cyclic citrullinated petide） antibodies,anti-keratin antibodies（anti-keratin antibody,AKA） and anti-perinuclear factor antibody（antiperinuclear factor,APF） joint detection in the diagnosis of juvenile idiopathic arthritis in value. Methods 61 cases of children with JIA and 20 patients with other rheumatic diseases in children,40 Cases of healthy children with three detection,and comparative analysis. Results Three testing positive indicators of children with JIA were significantly higher than normal, healthy children; the difference was statistically significant（P〈 0.01）. In the group of children with JIA anti-CCP,AKA, APF a sensitivity of 55.73%,39.34%,26.23%,the sensitivity of anti-CCP was higher than antibodies AKA and APF; the difference was statistically significant （P〈0.05）. Conclusion Although the sensitivi- ty of anti-CCP antibodies in children with JIA is lower than the sensitivity of adults RA, but the diagnosis of JIA has a higher sensitivity and specificity, especially for polyarticular and oligoarticular JIA diagnosis more valuable.