类风湿性关节炎患者血清RF、抗CCP抗体联合检测的临床意义

Clinical Significance of Combined Detection of Serum RF and Anti CCP Antibody in Patients with Rheumatoid Arthritis

目的探讨类风湿性关节炎(RA)患者血清类风湿因子(RF)、抗CCP抗体联合检测的临床意义.方法选择2015年3月至2016年1月来西安市第5医院治疗的86例RA患者作为RA组,同期在风湿免疫科住院的42例非RA患者作为非RA组,另外选择48例健康人群作为对照组,检测并比较3组血清RF、抗CCP抗体水平.结果 RA组血清RF、抗CCP抗体浓度及阳性率均明显高于非RA组及对照组,差异有统计学意义(P<0.05).单项检测时,RF指标的灵敏度、特异度分别为75.58%、83.33%;抗CCP抗体的灵敏度、特异度分别为70.93%、91.11%;两者联合检测时灵敏度、特异度分别为81.40%、88.89%.相关分析结果显示,RA患者血清RF与抗CCP抗体水平呈正相关(r=0.590,P=0.000).结论联合检测血清RF及抗CCP抗体来诊断RA可以弥补单纯检测RF诊断特异性低的缺点,对于早期诊断RA的敏感度也显著提高,从而可以减少误诊、漏诊,具有十分重要的临床应用价值.

Objective To investigate the clinical significance of combined detection CCP antibody in patients with rheumatoid arthritis （RA） . Methods Eighty-six patients of serum RF and anti with RA in The fifth hospital of Xi＇an City from March 2015 to January 2016 were selected as the RA group. Forty-two non RA patients hospitalized in the Department of immunology in the same period were selected as the Non RA group.In addition, 48 healthy people were selected as the control group. The serum RF, anti CCP antibody in all objects of study were detected and compared. Results Serum RF, anti CCP antibody concentration and positive rate in the RA group were significantly higher than those in the non RA group and the control group, the differences were statistically significant （P〈0.05） . The single detection, the sensitivity and specificity in RA group were 75.58%, 83.33% respectively, those of anti CCP antibody twere 70.93% and 91.11% respectively, those of the combined detection were 81.40%, 88.89%. Correlation analysis showed that the correlation of serum RF and anti CCP antibody in RA patients was positive （r=0.590, P=0.000） . Conclusions Combined detection of the serum level of RF and anti CCP antibody to diagnose RA can make up for the simple test of low RF diagnosis specific shortcomings, for diagnosis of early RA sensitivity increased significantly, which can reduce the misdiagnosis and missed diagnosis. It has very important clinical application value.