类风湿关节炎诊断中免疫学检验指标联合检测的应用价值分析

Value analysis of combined detection of immunological test indexes in the diagnosis of rheumatoid arthritis

目的主要探究类风湿关节炎诊断中免疫学检验指标联合检测的应用价值。方法选择50例类风湿关节炎患者作为研究组,同期50例健康者作为对照组。分别抽取两组静脉血3 ml,并进行类风湿因子(RF)、抗环瓜氨酸多肽(CCP)、免疫球蛋白G(IgG)、补体C3、补体C4检测。对比两组抗CPP、RF、 IgG、补体C3、补体C4水平;抗CPP和RF的阳性检出率。分析抗CPP、RF、 IgG、补体C3、补体C4五种指标单独及联合检测的敏感度和特异度。结果研究组抗CPP、RF水平分别为(240.15±92.33)IU/ml、(302.58±97.54)IU/ml,均高于对照组的(7.25±2.34)、(6.59±1.23)IU/ml,差异具有统计意义(P<0.05)。研究组抗CPP、RF阳性检出率分别为80.0%(40/50)、82.0%(41/50),均高于对照组的2.0%(1/50)、0,差异具有统计意义(P<0.05)。研究组IgG水平明显高于对照组,补体C3、补体C4水平明显低于对照组,差异均具有统计意义(P<0.05)。抗CPP、RF、 IgG、补体C3、补体C4单独检测敏感度分别为80.0%(40/50)、82.0%(41/50)、56.0%(28/50)、38.0%(19/50)、42.0%(21/50),特异度分别为98.0%(49/50)、100.0%(50/50)、86.0%(43/50)、84.0%(42/50)、80.0%(40/50);五种指标联合检测敏感度和特异度分别为32.0%(16/50)、100.0%(50/50)。结论血清中抗CPP、RF、 IgG、补体C3、补体C4水平与类风湿关节炎疾病的发生和发展具有密切关联,通过对这些免疫学检验指标进行联合检测,能有效提高疾病诊断准确性,在早期临床诊断中有着较高的应用价值。

Objective To investigate the practical value of combined detection of immunological test indexes in the diagnosis of rheumatoid arthritis. Methods There were 50 patients with rheumatoid arthritis selected as the research group, and 50 healthy patients during the same period as the control group. 3 ml of venous blood was collected from the two groups, and tested for rheumatoid factor(RF), anticyclic citrulline peptide(CCP), immunoglobulin G(IgG), complement C3, and complement C4. Comparison was made on levels of anti-CPP, RF, IgG, complement C3, and complement C4, and the positive detection rates of anti-CPP and RF between the two groups. The sensitivity and specificity of the five indicators of anti-CPP, RF, IgG, complement C3, and complement C4 individually and in combination were analyzed. Results The levels of anti-CPP and RF of the research group were(240.15±92.33) and(302.58±97.54) IU/ml, whcih were all higher than(7.25±2.34) and(6.59±1.23) IU/ml of the control group, and the difference was statistically significant(P<0.05). The positive rate of anti-CPP and RF of the research group were 80.0%(40/50) and 82.0%(41/50), which were all higher than 2.0%(1/50) and 0 of the control group, and the difference was statistically significant(P<0.05). The IgG level of the research group was obviously higher than that of the control group, and complement C3 and complement C4 were obviously lower than those of the control group. The difference was statistically significant(P<0.05). The sensitivity of anti-CPP, RF, IgG, complement C3 and complement C4 were 80.0%(40/50), 82.0%(41/50), 56.0%(28/50), 38.0%(19/50). 42.0%(21/50) respectively, and the specificity were 98.0%(49/50), 100.0%(50/50), 86.0%(43/50), 84.0%(42/50), 80.0%(40/50);the sensitivity and specificity of the combined detection of five indicators were 32.0%(16/50) and 100.0%(50/50). Conclusion The serum levels of CPP, RF, IgG, complement C3 and complement C4 are closely related to the occurrence and development of rheumatoid arthritis. The combined detection of immunological indicators can effectively improve the accuracy of diagnosis of the disease, and has a good practical effect in early clinical diagnosis.