红细胞沉降率、抗环瓜氨酸肽抗体、类风湿因子以及C反应蛋白在早期类风湿性关节炎诊治中的意义

The Significance of Erythrocyte Sedimentation Rate, Anti-Cyclic Citrullinated Peptide Antibody, Rheumatoid Factor and C-Reactive Protein in Early Rheumatoid Arthritis

目的评价类风湿性关节炎(RA)血清学指标红细胞沉降率(ESR)、抗环瓜氨酸肽(CCP)抗体、类风湿因子(RF)以及C反应蛋白(CRP)在RA诊治中的意义。方法选取130例早期RA患者作为早期RA组,120例其他自身免疫性疾病患者作为非RA组,90名健康体检者作为对照组。运用速率散射比浊法、自然沉降法、免疫比浊法检测血清ESR、抗CCP抗体、RF以及CRP水平,并分析4种检测指标在RA中的价值。结果早期RA组血清ESR、抗CCP抗体、RF和CRP水平及阳性检出率明显高于对照组及非RA组,差异均有统计学意义(P<0.05);单独检测RA的灵敏度依次为RF>CCP>ESR>CRP,特异度依次为CCP>RF>CRP>ESR;4项血清学指标分别以不同方式联合检测诊断RA,灵敏度提高,特异度下降。结论在RA患者的诊治中,血清ESR、抗CCP抗体、RF以及CRP存在一定的价值,且联合检测提高了RA的早期诊断率。

Objective To study the significance of rheumatoid factor（RF）, anti-cyclic citrullinated peptide（CCP） antibody, C-reactive protein（CRP） and erythrocyte sedimentation rate（ESR） in early rheumatoid arthritis（RA）. Methods Set up three groups; serum samples were collected from 130 early period RA patients, 120 non-RA patients（patients with other autoimmune diseases） and 90 healthy controls. Used rate scattering turbidimetry, natural sedimentation method, and immune turbidimetric method to detect the serum ESR, anti-CCP antibody, RF and CRP levels of all subjects, and did the statistical analysis of four detection indicators in the value of RA. Results Serum ESR, anti-CCP antibody, RF and CRP levels and positive detection rate in the early RA group were significantly higher than those in the control group and nonRA group, and the differences were statistically significant（P〈0.05）. The sort of sensitivity to RA was RFCCPESRCRP, and the sort of specificity was CCPRFCRPESR; Four serological indexes respectively joint detection in the diagnosis of RA in different ways, showed increased sensitivity and decreased specificity. Conclusion In the diagnosis and treatment of RA, ESR, anti-CCP antibody, RF and serum CRP have certain value, and the joint detection can improve the early diagnostic rate of RA.