四种抗体配合检测在类风湿性关节炎诊断中的价值

Diagnostic value of selective combining detection with anti-CCP,anti-MCV,RF and anti-RA33 in rheumatoid arthritis

目的探讨抗环瓜氨酸肽(CCP)抗体、抗突变型瓜氨酸波形蛋白(MCV)抗体、抗RA33抗体和类风湿因子(RF)在类风湿性关节炎(RA)中的临床应用价值。方法对103例RA患者、41例其他自身免疫病患者和104例健康人进行抗CCP抗体、抗MCV抗体、RF和抗RA33抗体测定,RF用速率散射免疫比浊法检测,其余三种抗体均使用相对应的试剂盒用酶联免疫吸附试验(ELISA)测定。结果 RA患者中抗CCP抗体、抗MCV抗体、类风湿因子的阳性率分别为74.8%、80.6%、91.3%明显高于非RA组(P<0.01)。抗CCP抗体、抗MCV抗体和抗RA33抗体的特异性高达97.2%、97.9%和95.9%。三组(抗CCP抗体、抗MCV抗体、RF联合检测组和抗MCV抗体、抗RA33抗体、RF联合检测组和四种抗体共同检测组)联合检测均出现高特异性99.3%,但敏感度较低。结论 RA相关抗体抗CCP抗体或抗MCV抗体与RF的联合检测具有较好敏感性和特异性,此结果可用于RA的早期诊断预防不可逆性骨损伤。抗RA33抗体对早期症状不明显的RA患者可作为一个较好辅助指标。

Objective To investigate the clinical value of joint detection of anti-cyclic citrullinated peptide （anti- CCP） antibody, anti-mutant citrullinated vimentin （anti-MCV） antibody, eumatoid factor （RF） and anti-RA33 anti- body in rheumatoid arthritis （RA）. Methods The serum samples of 103 patients with RA,41 patients With other autoimmune diseases and 104 healthy person were collected. The levels of RF were measured by the rate scatting im- munity methods. The expression of anti-CCP and anti-MCV and RA33 were measured by ELlS methods. Results The positive rate of anti-CCP,anti-MCV and RF in patients with RA was significantly higher than those patients with no RA （P 〈 O. 01 ）, the sensitivity were 74.8%, 80.6%, 91.3%. The three antibodies＇s specificity were 97.2%, 97.9% ,95.9% of antibodies. There were 99.3% specificity in three groups （combination of anti-CCP and anti-MCV and RF, combination of anti-MCV and RA33 and RF, four antbodies combining detection group） , but the sensitivity of them were low. Conclusion The joint detection of RA related antibodies such as against CCP antibody or MCV anti- body and RF has a good sensitivity and specificity. It can be used for the early diagnosis of RA and preventing irrevers- ible bone injury. Anti RA33 antibodies is a good auxiliary index for RA. patients with no obwious symptoms.