评估RF、抗CCP、AKA、GPI联合检测在类风湿关节炎诊断中的价值

Evaluation of the Value of Combined Detection of RF, anti-CCP, AKA and GPI in the Diagnosis of Rheumatoid Arthritis

目的探讨类风湿因子(RF)、抗角蛋白抗体(AKA)、抗环瓜氨酸多肽抗体(抗CCP)及葡萄糖-6-磷酸异构酶(GPI)4种血清标记物联合检测对类风湿关节炎(RA)的临床价值。方法方便选取2014年1月-2018年12月期间在该院就诊的80例RA患者为研究组对象,以同期65名健康志愿者为对照组。两组人员均检测这4种血清标记物,观察单一检测和联合检测的准确率。结果研究组患者RF(32.17±5.43)IU/mL、抗CCP(28.75±2.98)U/mL、AKA(55±7)、GPI(4.56±1.34)mg/mL平均值均显著高于对照组RF(18.44±3.39)IU/mL、抗CCP(8.54±1.07)U/mL、AKA(15±5)、GPI(0.22±0.25)mg/mL(t=12.829、17.103、16.827、20.505,P<0.05)。单一标志物检测时,RF的敏感性81.25%最高,抗CCP特异性95.38%最高;两两联合检测中RF联合抗CCP敏感度68.75%最高,抗CCP联合AKA特异性96.92%最高;两项以上联合检测时四者联合检测特异性98.46%最高。结论对于RA的检测可以RF、抗CCP、AKA、GPI 4种血清标记物联合检测,以提高诊断准确率。

Objective To observe the combined detection of four serum markers including rheumatoid factor(RF), anti-keratin antibody(AKA), anti-cyclic citrullinated peptide antibody(anti-CCP) and glucose-6-phosphate isomerase(GPI) Clinical value for rheumatoid arthritis(RA). Methods A total of 80 RA patients who were convenient admitted to the hospital from January 2014 to December 2018 were enrolled in the study. 65 healthy volunteers in the same period were used as the control group. The two groups of serum samples were tested for the accuracy of single and combined detection. Results The mean values of RF(32.17±5.43) IU/mL, anti-CCP(28.75±2.98) U/mL, AKA(55±7), and GPI(4.56±1.34) mg/mL were significantly higher in the study group than in the control group(18.44±3.39) IU/mL, anti-CCP(8.54±1.07) U/mL, AKA(15±5),GPI(0.22±0.25) mg/mL(t=12.829,17.103,16.827,20.505,P<0.05). When the single marker was detected, the sensitivity of RF was 81.25%, and the anti-CCP specificity was 95.38%. The combined anti-CCP sensitivity of 68.75% was the highest in the combined detection, and the anti-CCP combined AKA specificity was 96.92%. The combined detection accuracy of the four tests was the highest at 98.46%. Conclusion For the detection of RA, four serum markers, RF, anti-CCP, AKA and GPI, can be combined to improve the diagnostic accuracy.