抗-CCP、AKA和RF联合检测在RA早期诊断中的应用价值

The value of combined detection of anti-CCP,AKA,and RF in the early diagnosis of patients with RA

目的探讨抗-CCP、AKA、RF联合检测在类风湿关节炎(RA)早期诊断中的应用价值。方法收集RA患者154例作为实验组,另选择非RA患者156例及健康者150例作为对照组,运用ELISA法检测抗-CCP水平,免疫比浊法检测RF水平,间接免疫荧光染色法检测AKA水平。结果实验组抗-CCP、AKA、RF、抗-CCP+AKA、AKA+RF、抗-CCP+RF及抗-CCP+AKA+RF的阳性率分别为75. 3%、54. 5%、79. 9%、57. 1%、63. 6%、70. 1%、56. 5%。灵敏度最高的为RF检测(79. 9%),特异度和阳性预测值最高的为三项联合检测(分别为94. 8%、84. 5%),阴性预测值最高的为RF检测(88. 2%)。结论运用联合检测的手段,可有效降低RA早期诊断漏诊率和误诊率,提高早期诊断率,具有重要的临床意义。

Objective To explore the value of combined detection of anti - CCP,AKA and RF in early diagnosis of RA. Methods 154 patients with RA were recruited as experimental group,and 156 non - RA patients and 150 healthy patients were taken as control group. The level of anti - CCP was detected by ELISA,and RF level was detected by immunoturbidimetric assay,and the level of AKA was detected by indirect immunofluorescence staining. Results In the experimental group,the positive rates of anti - CCP,AKA, RF,anti - CCP + AKA,AKA + RF,anti - CCP + RF and anti - CCP + AKA + RF were 75. 3%,54. 5%,79. 9%,57. 1%,63. 6%, 70. 1%,56. 5%,respectively. The highest sensitivity was detected by RF (79. 9%) . The highest specificity and positive predictive value were three combined tests (94. 8% and 84. 5%,respectively ) . The highest negative predictive value was RF (88. 2%) . Conclusion Use of joint detection methods can effectively reduce the rate of missed diagnosis and misdiagnosis,and improve the early diagnosis rate of RA patients,which has important clinical significance.