抗环瓜氨酸抗体和类风湿因子在诊断类风湿关节炎的临床应用价值

The clinical application value of anti-cyclic citrullinated peptide antibody and rheumatoid factor in rheumatoid arthritis

目的探讨抗环瓜氨酸肽抗体（抗-CCP抗体）和类风湿因子（RF）在类风湿关节炎（RA）诊断中的临床应用价值。方法分别检测RA组180例、健康对照组59例的抗CCP抗体、RF血清水平，分析其在RA组和健康对照组间的关系，并应用受试者工作特征曲线（ROC）进行分析。结果RA组的抗环瓜氨酸肽抗体（抗-CCP抗体）和类风湿因子（RF）水平明显高于健康对照组组，两种比较间有显著差异（P〈0．05），抗CCP抗体用于诊断RA患者的曲线下面积（AUC）高于RF，抗CCP抗体用于诊断RA的AUC为0．877（CI：81．7％～93．8％），敏感度为77．2％，特异度为91．6％。结论抗CCP抗体在RA诊断中具有较高的特异性，可作为诊断RA的理想血清学指标，抗CCP抗体和RF联合检测可提高检测的特异度和敏感度。

Objective To explore the clinical application of anti-cyclic citrullinated peptide antibody and rheumatoid factor in rheumatoid arthritis. Methods To examine and analyze the serum levels of anti-cyclic citrullinated peptide antibody and rheumatoid factor in patients （n=59） with rheumatoid arthritis,in healthy control group（n= 180）, to analyze the relationship in the different groups about each index,to analyze the result by ROC method. Results CCP and RF levels of patients with rheumatoid arthritis was significantly higher than healthy control g rotlp, there was statistically significant differences （P〈0.05）. The area under the ROC curve （AUC） of CCP was bigger than RF for diagnosing rheumatoid arthritis. The AUC was 0. 877（CI：81.7%-93.8%）, sensitivity was 77.2%, specificity was 91.6%, for diagnosing, rheumatoid arthritis by CCP. Conclusion The anti-cyclic citrullinated pepeide antibody might be high specificity for diagnosis of RA, and could be an ideal serologicial index for the diagnosis of RA. Combined detection of Anti-cyclic citrullinated peptide antibody and Rheumatoid factor could increase the diagnostic specificity and sensitivity.