肽酰基精氨酸脱亚氨酶-4、抗环瓜氨酸肽抗体联合检测在类风湿关节炎诊断中的应用价值

The application value of the combined detection of peptidylarginine deaminase-4 and anti-cyclic citrullinated peptide antibody in the diagnosis of rheumatoid arthritis

目的:研究肽酰基精氨酸脱亚胺酶-4(PADI-4)、抗环瓜氨酸抗体(抗CCP抗体)联合检测在类风湿关节炎(RA)诊断中的价值。方法:用酶联免疫吸附试验双抗体夹心法检测58例RA患者(RA组)、40例其他风湿性疾病患者(非RA组)和30名健康志愿者(健康对照组)的血清PADI-4、抗CCP抗体、抗聚角蛋白傲丝蛋白抗体(AFA)、抗突变型瓜氨酸波形蛋白抗体(抗MCV抗体)和抗RA33抗体的浓度,并对其受试者工作特征曲线、灵敏度、特异度、相关性和诊断效能进行分析。结果:RA患者血清中PADI-4、抗CCP抗体、AFA、抗MCV抗体和抗RA33抗体的浓度均显著高于非RA组和健康对照组(P<0.01);采用受试者工作特征曲线,PADI-4和抗CCP抗体诊断RA的最佳临界值为1.284 U/L和26.365 RU/m L,此时的灵敏度为62.1%和81.1%,特异度为91.4%和95.7%;PADI-4与AFA、抗RA33抗体、抗MCV抗体均呈明显正相关关系(P<0.01);PADI-4与抗CCP抗体无相关关系(P>0.05)。在多种抗体联合检测中,PADI-4、抗CCP抗体均为阳性诊断RA的特异度高达100.0%,单项检测PADI-4为91.4%,抗CCP抗体为95.7%。结论:PADI-4、抗CCP抗体联合检测能提高RA的特异性和灵敏度,有助于对RA的诊断。

Objective：To investigate the value of the combined detection of peptidylarginine deaminase-4 （ PADI-4 ） and anti-cyclic citrullinated peptide（anti-CCP） antibody in the diagnosis of rheumatoid arthritis（RA）. Methods：The levels of PADI-4,anti-CCP antibody,anti-MCV antibody, AFA antibody and anti-RA33 antibody in 58 patients with RA （ RA group ） , 40 patients with other rheumatoid disease （ non-RA group ） and 30 healthy people （ control group ） were detected by ELISA. The ROC curve, sensitivity, specificity,relevance and diagnostic effectiveness in all cases were analyzed. Results：The serum levels of PADI-4,anti-CCP antibody, anti-MCV antibody,AFA antibody and anti-RA33 antibody in RA patients were significantly higher than those in non-RA group and control group（P〈0. 01）. The ROC curve showed that the best critical value of PADI-4 and anti-CCP antibody in the diagnosis of RA were 1. 284 U/L and 26. 365 RU/mL,the sensitivity and specificity of PADI-4 and anti-CCP antibody were 62. 1% ＆ 81. 1% and 91. 4% ＆95. 7%,respectively. PADI-4 was positive correlation with AFA antibody,anti-RA33 antibody and anti-MCV antibody（ P〈0. 01）,but the PADI-4 was not correlation with anti-CCP antibody（P〉0. 05）. Among the combined detection of multiple antibodies, the specificity of the PADI-4 and anti-CCP antibody in the diagnosis of RA was 100. 0%,and the positive detection of PADI-4 and anti-CCP antibody were 91. 4% and 95. 7%, respectively. Conclusions：The combined detection of PADI and anti-CCP antibody can improve the specificity and sensitivity of RA,which can help the diagnosis of RA.