葡萄糖-6磷酸异构酶抗原与类风湿因子联合检测在类风湿关节炎诊断中的应用及探讨

Application of combined detection of glucose-6-phosphate isomerism and rheumatoid factor in the diagnosis of rheumatoid arthritis

目的探讨葡萄糖-6-磷酸异构酶（GPI）与类风湿因子（RF）等指标在类风湿关节炎（RA）诊断中的应用。方法采用酶联免疫吸附试验检测92例类风湿性关节炎患者（活动组60例，非活动组32例）、78例非类风湿关节炎的自身免疫性疾病和56例健康对照者中GPI浓度，免疫比浊法检测RF浓度，同时检测上述人群C反应蛋白（CRP）与红细胞沉降率（ESR），并进行统计学分析。结果（1）RA组中血清GPI的浓度明显高于疾病对照组及健康对照组，差别具有统计学意义（P〈0．05）。（2）GPI敏感性和特异性为79．3％和90．3％，RF敏感性和特异性为82．6％和69．4％；（3）CRP敏感性（65．2％）、特异性（63．4％）与ESR敏感性（55．4%）特异性（52．2%）两者均低于上述两种检测方法。（4）GPI与RF联合检测能显著提高对类风湿关节炎诊断的特异性（97．0％）。结论GPI与RF联合检测可显著提高RA诊断的特异性，为临床提供有力的参考。

Objective To explore the applications of glucose-6 - phosphate isomerism （GPI） and rheumatoid factor （RF） to the diagnosis of rheumatoid arthritis. Methods Peripheral blood samples were collected from 92 cases of patients with rheumatoid ar-thritis （60 cases of active RA groups,RA inactive group of 32 patients）,and 78 cases of other autoimmune disease and 56 healthy controls. The concentration of serum GPI and RF were detected by double antibody sandwich enzyme-linked immunosorbent assay （ELISA） and turbid metric immunoassay. At the same time, the level of serum CRP and ESR were assessed for statistical analysis. Results ①The concentration of GPI in RA group were significantly higher than those in disease control and normal control group （P〈0.05） ② GPI sensitivity （79.3 %） ,specificity （90.3%） ,RF sensitivity （ 82.6% ） ,specificity（69.4%）. ③The CRP sensitivi- ty （65.2%） and specificity （63.4M）,ESR sensitivity （55.4%） and specificity （52.2 % ） are lower than the two detection methods. ④Combining detection of GPI and RF can significantly improve the diagnostic specificity of rheumatoid arthritis （97.0 %）. Conclusion Combining detection of GPI and RF can improve the specificity that makes the diagnosis of RA with higher accuracy.