抗突变型瓜氨酸波形蛋白抗体在类风湿关节炎中的诊断效能

Efficacy of Anti-mutated Citrullinated Vimentin Antibody in Diagnosis of Patients with Rheumatoid Arthritis

目的探索抗突变型瓜氨酸波形蛋白(MCV)抗体对类风湿关节炎(RA)的诊断价值。方法选取2017年12月30日—2018年6月30日风湿免疫系统疾病患者162例。根据是否诊断为RA分为RA组78例、非RA组84例。同期选取63名健康人作为正常对照组。采集3组的血样进行抗MCV抗体与抗环瓜氨酸肽(CCP)抗体检测,对比其诊断价值。结果抗MCV抗体检测的敏感度与抗CCP抗体检测比较差异无统计学意义(P>0.05),而特异度低于抗CCP抗体检测(P<0.05);并联检测的敏感度高于抗MCV抗体检测(P<0.05),而特异度与抗MCV抗体检测比较差异无统计学意义(P>0.05);串联检测的敏感度低于抗MCV抗体检测(P<0.05),而特异度高于抗MCV抗体检测(P<0.05)。其中以并联检测的敏感度、总符合率和Youden指数最佳。相较于正常对照组,抗MCV抗体和抗CCP抗体检测的ROC曲线下面积(AUC)分别为0.971和0.953;而相较于非RA组,抗MCV抗体和抗CCP抗体检测的AUC分别为0.940和0.908。抗MCV抗体和抗CCP抗体最优界值分别为16.7 U/ml和26.1 RU/ml。结论抗MCV抗体检测对RA有较高的诊断价值,与抗CCP抗体并联检测可提高诊断效能。

Objective To investigate value of anti-mutant citrullinated vimentin(MCV)antibody in diagnosis of rheumatoid arthritis(RA).Methods A total of 162 patients with rheumatic immune system diseases from December 30,2017 to June 30,2018 were divided into RA group(n=78)and non-RA group(n=84)according to whether or not having RA.At the same time,63 healthy persons were selected as control group.Blood samples were collected for detection of anti-MCV antibody and anti-cyclic citrullinated peptide(CCP)antibody in order to compare their diagnosed value.Results There was no significant difference in sensitivity between anti-MCV antibody and anti-CCP antibody detections(P>0.05),while the specificity by anti-MCV antibody detection was significantly lower than that by anti-CCP antibody detection(P<0.05).The sensitivity by parallel detection was significantly higher than that by anti-MCV antibody detection(P<0.05),but there was no significant difference in specificity between parallel detection and anti-MCV antibody detection(P>0.05).The sensitivity by tandem detection was significantly lower than that by anti-MCV antibody detection(P<0.05),while the specificity was significantly higher than that by anti-MCV antibody detection(P<0.05).Among them,values of sensitivity,the total coincidence rate and Youden index by parallel connection detection were the best.Control group was used as the basis,areas under receiver operating curve(ROC)curve(AUC)of anti-MCV and anti-CCP antibodies were 0.971 and 0.953 respectively,while the AUC values of anti-MCV and anti-CCP antibodies were 0.940 and 0.908 respectively,as non-RA group was used as basis.The optimal thresholds values of anti-MCV and anti-CCP antibodies were 16.7 U/ml and 26.1 RU/ml respectively.Conclusion The detection of anti-MCV antibody has good value in diagnosis of RA.Parallel detection with anti-CCP antibody may improve diagnostic efficiency.