RF、抗CCP抗体、GPI和抗RA33抗体联合检测在类风湿关节炎中的临床意义

Clinical significance of combined detection of RF,anti-CCP antibody,GPI and anti-RA33 antibody in rheumatoid arthritis

目的通过联合检测类风湿因子(RF)、抗环瓜氨酸(CCP)抗体、葡萄糖-6-磷酸酶(GPI)和抗RA33抗体,探讨其在类风湿关节炎(RA)中的诊断意义。方法选取确诊的RA患者126例(RA组),其他自身免疫病患者60例(自免组)及体检健康人群60例(对照组)作为研究对象。分析单独和联合检测RF、抗CCP抗体、GPI和抗RA33抗体在RA诊断中的作用。结果 RA组4项指标与对照组比较均升高,差异有统计学意义(P<0.05);自免组RF与对照组比较也升高,差异有统计学意义(P<0.05)。RA组4项指标与自免组比较均升高,差异有统计学意义(P<0.05)。RF对RA的敏感度和特异度为77.77%和63.33%;抗CCP抗体对RA的敏感度和特异度为69.04%和95.00%;GPI对RA的敏感度和特异度为25.40%和100.00%;抗RA33抗体对RA的敏感度和特异度为27.77%和99.16%。联合检测两项,特异度由原来的63.33%增加到85.00%,联合3个指标,特异度就增加到了93.33%,联合4项指标,特异度高达100.00%。结论 RF、抗CCP抗体、GPI和抗RA33抗体4项指标联合用于RA诊断,其敏感度和特异度都有了很大的提高,具有临床意义。

Objective To investigate the diagnostic significance of combined detection of rheumatoid factor（RF）,anti-cyclic citrullinated antibody（anti-CCP antibody）,glucose-6-phosphatase（GPI）and anti-RA33 antibody in rheumatoid arthritis（RA）.Methods One hundred and twenty-six patients with RA,60 patients with other autoimmune diseases and 60 healthy subjects undergoing physical examination were selected as the research subjects.The singled detection of RF,anti-CCP antibody,GPI and anti-RA33 antibody,and their combined detection were used to analyze their roles in RA diagnosis.Results Compared with the healthy control group,the four indexes in the RA group were increased,the difference was statistically significant（P〈0.05）,the RF level in the autoimmune diseases group was increased compared with the control group,the difference was statistically significant（P〈0.05）.Compared with the the autoimmune diseases group,the four indexes in the RA group were increased,the difference was statistically significant（P〈0.05）.The sensitivity and specificity of RF to RA were 77.77%and 63.33%;the sensitivity and specificity of antiCCP antibody to RA were 69.04%and 95.00%;the sensitivity and specificity of GPI antibody to RA were 25.40%and 100.00%;the sensitivity and specificity of anti-RA33 antibody were 27.77% and 99.16%,respectively.The specificity of combined 2indicators was increased from 63.33%to 85.00%,which of combined 3indicators was increased to 93.33% and which of combined 4indicators even reached to 100.00%.Conclusion The combination of RF,anti-CCP antibody,GPI and anti-RA33 antibody indicators greatly increases with the sensitivity and specificity for diagnosing RA and has clinical significance.