3种血清学抗体检测在类风湿关节炎的诊断意义

Value of three serum markers in the diagnosis of rheumatoid arthritis

目的评价类风湿因子(RF)、抗环瓜氨酸抗体(抗CCP)、抗葡萄糖-6-磷酸异构酶抗体(抗GPI)在类风湿关节炎诊断中的应用价值。方法对类风湿关节炎(RA)患者80例、非RA患者73例分别采用速率散射免疫比浊法测定RF、酶联免疫吸附测定(ELISA)检测抗CCP和抗GPI,采用诊断灵敏度、特异度、阳性预测值预测值等指标评价RF、抗CCP、抗GPI单独及联合检测对RA的诊断效能,观察各项血清学指标对RA的诊断价值。结果RA组RF、抗CCP、抗GPI的阳性率显著高于非RA组(P<0.05),RF、抗CCP、抗GPI对诊断RA的敏感性依次为88.8%、71.3%、50.0%(P<0.05),特异性依次为83.5%、97.2%、94.5%(P<0.05),阳性预测值依次为87.7%、96.6%、90.9%(P<0.05),3种抗体联合检测,敏感度达98.4%,特异度99.9%。结论血清RF、抗CCP、抗GPI 3种抗体在诊断RA中均具有较高的敏感性和特异性,其中抗CCP的诊断价值最大,三者联合可明显提高患者的诊断率。

Objective To assess the diagnostic value of rheumatoid factor（ RF）,Anti-cyclic citrullinated peptide antibody（ anti-CCP）,anti-glucose-6-phosphate isomerase（ GPI） for rheumatoid arthritis. Methods The serum samples of 100 patients with RA,53 non-RA rheumatic patients were collected,the level of RF was measured by the rate scatting immunity methods,the expression of anti-CCP and anti-glucose-6-phosphate isomerase（ GPI） were measured by ELISA methods. Results The sensitivities in detection of RF,anti-CCP,anti-GPI were 88. 8%,71. 3%,50. 0%,the specificities were 81. 0%,96. 2%,92. 5%,the positive predictive values were 87. 7%,96. 6%,90. 9%,when united with the three antibodies,the sensitivity and specificity of combined detection of RF,anti-CCP,anti-GPI were 98. 4%,99. 9%. Conclusion In comparison of detection of three antibodies,the specificity in detection of CCP is the highest,combined detection of three antibodies will improve the specificity in diagnosis of RA.