AKA、anti－CCP抗体检测在类风湿性关节炎诊断中的应用价值比较

Comparison of Anti-Cyclic Citrullinated Peptide Antibody、Anti-Keratin Antibody in Diagnosis of Rheumatoid Arthritis

目的：探讨抗角蛋白抗体（ AKA）、抗环瓜氨酸肽抗体（ anti－CCP）在类风湿性关节炎（ RA）诊断中的应用价值。方法：173例患者均来自2014年1月～2015年1月南阳医专一附院门诊及住院患者，依据美国风湿病学会（ ACR ）1987年修订的RA诊断标准，分为90例RA患者组，83例非RA组，37名健康人群组来自同期体检人群。用ELISA方法检测anti－CCP；用间接免疫荧光法检测AKA；用速率散射比浊法检测类风湿因子（ RF），观察各指标对RA的诊断价值。结果：anti－CCP与AKA在RA患者血清中的阳性率之间差异非常显著（P＜0．01），与RF差异不显著（P＝0．139）。 anti－CCP敏感性与RF无差别（P＝0．12），特异性高于AKA（P＜0．05），高于RF（P＜0．05）。结论：与RF相比，anti－CCP和AKA对类风湿关节炎的诊断具有高度的敏感性和特异性，尤其是anti－CCP。3种抗体联合检测，可提高RA的确诊率。

Objective：To assess the application of anti-cyclic citrullinated peptide（anti-CCP）,antibody anti-keratin antibody （ AKA） in diagnosis of rheumatoid arthritis（ RA） .Methods：173 patients all from the outpatient and inpatient visits to Nanyang medical college first affiliated hospital between 2014.01 to 2015.12,according to the diagnostic criteria of RA 1987 amendment by ACR,divided into 90 RA patients,83 non-RA patients.37 normal healthy people were from the examination people in the same period.Serum level of RF、AKA and anti-CCP were respectively examined by rate nephelometry method , indirect immunofluorescence（ IIF） and ELISA.Ob-serve the value of three indicators in diagnosis of RA.Results： The data showed that there was a significant difference between the two methods of anti-CCP and AKA assaying（P〈0.01）.However,no difference was found between anti -CCP and RF assaying（P=0. 139）.There was no difference between the sensitivity of anti-CCP and RF（P=0.12）,the specificity of anti-CCP was higher than that of AKA （P 〈0.05）, and RF （P 〈0.05）.Conclusion：Compared with RF, anti-CCP and AKA have high sensitivity and specificity in diagnosis of rheumatoid arthritis, especially anti-CCP.Detect three antibodies simultaneously could improve the diagnosis rate of RA.