类风湿关节炎早期诊断中抗环瓜氨酸肽抗体检测的意义

Value of anti-cyclic peptide containing citrulline antibody for the early diagnosis of rheumatoid arthritis

目的探讨单独或联合检测抗环瓜氨酸肽抗体（anti-CCP）、类风湿因子（RF）对类风湿关节炎（RA）早期诊断的价值。方法选取2012—2014年门诊及住院患者1961例，已确诊为RA患者共509例（RA组），非RA患者共1028例（非RA组），初步诊断非RA，随诊确诊为RA患者424例（初诊非RA随诊为RA组），分别采用速率散射比浊法检测RF；电化学发光法检测anti．CCP。结果RA组与非RA组比较，单独检测anti-CCP与联合检测anti—CCP／RF的敏感度比较差异无统计学意义（P〉0．05），而特异度（88．6％比60．4％）比较差异有统计学意义（P〈0．05）；而单独检测anti—CCP与单独检测RF的敏感度（81．7％比74．3％）和特异度（88．6％kk66．0％）比较差异有统计学意义（P〈0．05）；在初诊非RA随诊为RA组，单独检测anti—CCP与单独检测RF的敏感度（98．3％比82．1％）及特异度（91．6％比81．5％）比较差异有统计学意义（P〈0．05）。结论单独检测anti．CCP对RA的早期诊断具有重要价值。

Objective To investigate the value of detection of anti-cyclic peptide containing citrulline （anti-CCP） antibody, rheumatoid factor （RF） and the combined detection of anti-CCP antibody and RF in rheumatoid arthritis （RA） patients. Methods From 2012 to 2014,1 961 patients were divided into three groups： diagnosed RA group（509 patients）, not RA group（1 028 patients） and firstly was not diagnosed RA but later was diagnosed RA group （424 patients）. The levels of RF and anti-CCP antibody were separately measured by rate nephelometry method and the electrochemical lumlnescence method. Results The sensitivity of detecting by anti-CCP antibody alone or anti-CCP antibody in combination with RF between RA group and not RA group was not significant difference （P 〉 0.05）, but the specificity between two groups （88.6% vs. 60.4%） was significant difference （P 〈 0.05）. There were significant differences in the sensitivity （81.7% vs. 74.3%） and specificity （88.6% vs. 66.0%） between by using anti-CCP antibody alone and RF alone.In firstly was not diagnosed RA but later was diagnosed RA group, there were significantly difference in sensitivity （98.3% vs. 82.1%） and specificity （91.6% vs. 81.5%） by using anti-CCP antibody alone and RF alone. Conclusion There is important clinical value by using anti-CCP antibody alone for the early diagnosis of RA.