血清RF、抗CCP抗体、CRP及免疫球蛋白联合检测在类风湿性关节炎的诊断价值

The Diagnostic Value of Combined Detection of Serum RF, Anti-CCP Antibody,CRP and Immunoglobulin in Patients with Rheumatoid Arthritis

目的探讨血清RF、抗CCP抗体、CRP及免疫球蛋白对类风湿性关节炎(RA)的诊断价值。方法选取2014年1月—2016年12月在玉林市第一人民医院就诊55名健康体检者作为阴性对照组,100例非RA的自身免疫性疾病患者作为病例对照组,93例类风湿性关节炎(RA)患者作为病例组,分析比较RF、抗CCP抗体、CRP、ERS、免疫球蛋白及补体相关指标。结果 RA组较对照组及非RA组的RF、抗CCP抗体、CRP及ESR均明显升高(P<0.05);非RA组较对照组抗CCP抗体、CRP及ESR均明显升高(P<0.05)。RA组较对照组及非RA组的IgA、C3均明显升高(P<0.05);RA组、非RA组较对照组Ig G均明显升高(P<0.05)。Spearman相关分析发现RA患者血清中RF与IgA呈正相关(r=0.280,P=0.007),抗CCP抗体与ESR、CRP和IgA之间呈正相关(r=0.248,P=0.016;r=0.290,P=0.005;r=0.228,P=0.028)。3种指标联合检测下的灵敏度为92.5%,特异度为90.5%,准确度为94.8%,阳性似然比为1.03,阴性似然比为0.08。结论联合检测RF、抗CCP抗体、CRP对诊断RA的准确率高,ESR、免疫球蛋白及补体检测有助于RA患者的疾病活动及预后的判断具有重要意义。

Objective This paper tries to investigate the diagnostic value of serum RF, anti-CCP antibody, CRP and immunoglobulin in patients with rheumatoid arthritis（RA）. Methods A total of 55 healthy subjects were selected as the negative control group, 100 pa-tients with non-RA autoimmune diseases as the case control group, 93 patients with rheumatoid arthritis（RA） as a case group in this hospital from January 2014 to December 2016, the RF, anti-CCP antibody, CRP, ESR, immunoglobulin and complement related indicators were analyzed and compared. Results The levels of RF, anti-CCP antibody, CRP and ESR were significantly increased in the RA group compared with the control group and the non-RA group（P〈0.05）; the levels of anti-CCP antibody, CRP and ESR in the non-RA group were significantly higher than the control group（P 〈0.05）. The levels of IgA, C3 in RA group were significantly increased compared with the control group and the non-RA group（P〈0.05）. The level of Ig G in the RA group and the non-RA group was significantly higher than the control group（P 〈0.05）. Spearman correlation analysis showed that there was a positive correlation between RF and IgA（r=0.280, P=0.007） and there was a positive correlation between anti-CCP antibody and ESR, CRP and IgA in serum of the RA patients（r=0.248, P=0.016; r=0.290, P=0.005; r=0.228, P=0.028）. The sensitivity of the three indicators was 92.5%,the specificity was 90.5%, the accuracy rate was 94.8%, the positive likelihood ratio was 1.03, and the negative likelihood ratio was0.08. Conclusion Combined detection of RF, anti CCP antibody and CRP has a high accuracy in the diagnosis of RA, and the detection of ESR, immunoglobulin and complement is of great significance in the evaluation of disease activity and prognosis of patients with RA.