类风湿关节炎诊断中应用免疫学检验联合检测的临床应用价值

Clinical value of combined immunological examination in the diagnosis of rheumatoid arthritis

目的:探究免疫学检验联合检测在类风湿关节炎(Rheumatoid Arthritis,RA)诊断中应用价值。方法:抽选广州中医药大学顺德医院附属均安医院2017年11月-2018年11月接收的RA患者40例,设为RA组,并取同时期收治的患有其他类型自身免疫系统疾病患者40例,设为对照1组;取40例于广州中医药大学顺德医院附属均安医院接受健康体检正常者40例,设为对照2组;三组均借助免疫比浊法检测类风湿因子(Rheumatoid Factors,RF),借助酶联免疫吸附法(Enzyme-Linked Immunosorbent Assay,ELISA)定量检测抗环瓜氨酸肽抗体(Cyclic Citrullinated Peptide,CCP)及抗RA33抗体;并借助免疫荧光法检测抗角蛋白抗体(Anti Keratin Antibody,AKA)水平,对比三组四项指标阳性率,并分析其特异性,敏感性。结果:研究组抗RA33、抗AKA、抗CCP阳性率相比其余两组更高,且RF在RA诊断中具有较高敏感度,但抗RA33、抗AKA、抗CCP诊断RA特异性更高(P <0.05)。结论:抗RA33、抗AKA、抗CCP在RA早期即可出现,且具有极高特异性,可有效提高早期诊断率,具有较高临床诊断价值。

Objective:To explore the value of immunological examination combined with detection in the diagnosis of rheumatoid arthritis(RA).Methods:40 patients with RA admitted to our hospital from November 2017 to November 2018 were selected as the RA group,and 40 patients with other types of autoimmune diseases admitted in the same period were selected as the control group 1.40 patients who received normal physical examination in our hospital were selected as control group 2.All three groups were tested for rheumatoid factor(RF)by immunoturbidimetry,and anti-cyclic citrulline peptide(CCP)and anti-ra33 antibodies by ELISA.The level of anti-keratin antibody(AKA)was detected by immunofluorescence method,and the positive rates of four indicators in three groups were compared,and their specificity and sensitivity were analyzed.Results:The positive rate of anti-RA33、anti-AKA and anti-CCP in the study group was higher than that in the other two groups,and RF had higher sensitivity in RA diagnosis,but the specificity of anti-RA33、antiAKA and anti-CCP in RA diagnosis was higher(P<0.05).Conclusion:Anti-RA33、anti-AKA and anti-CCP can appear at the early stage of RA,and have high specificity,which can effectively improve the early diagnosis rate and have high clinical diagnostic value.