抗瓜氨酸化α烯醇化酶多肽1抗体对类风湿关节炎诊断的临床价值

Clinical value of anti-citrullinated α-enolase polypeptide 1 antibody in diagnosing rheumatoid arthritis

目的分析抗瓜氨酸化α烯醇化酶多肽1(CEP-1)抗体对类风湿关节炎(RA)患者的诊断价值。方法选取2020年1月至2021年12月在漳州市中医院就诊的118例RA患者(RA组)和114例非RA患者(非RA组)以及120名健康体检者(对照组)作为研究对象,分别测定各组间的抗瓜氨酸化蛋白抗体(ACPA)包括血清抗CEP-1抗体、抗环状瓜氨酸多肽(CCP)抗体、抗角蛋白抗体(AKA)、抗核周因子抗体(APF)和类风湿因子(RF)的阳性率,并对各指标的诊断效能进行比较。结果RA组患者的血清抗CEP-1抗体、抗CCP抗体、AKA、APF和RF的阳性率高于非RA组和对照组(P<0.05)。且RA患者中抗CEP-1抗体的敏感度高于AKA和APF,准确度高于AKA、APF和RF,差异有统计学意义(均P<0.05)。血清抗CEP-1抗体在抗CCP抗体、AKA、APF、ACPA、RF阴性以及ACPA和RF双阴性的RA患者中的阳性率分别为34%、49%、47%、30%、38%和22%。结论抗CEP-1抗体对RA患者的诊断准确率较高,且联合其他自身抗体检测有助于提高RA的诊断效能。

Objective To determine the diagnostic value of anti-citrullinatedα-enolase polypeptide 1(CEP-1)antibody in patients with rheumatoid arthritis(RA).Methods One hundred and eighteen RA patients(RA group),114 non-RA patients(non-RA group)and 120 health checkup subjects(control group)who visited our hospital between January 2020 and December 2021 were included in the study.For these sub-jects,the positivity of anti-citrullinated protein-like antibodies(ACPA)including serum anti-CEP-1 anti-body and anti-cyclic citrullinated polypeptide(CCP)antibody,anti-keratin antibody(AKA),anti-perinuclear factor(APF)antibody and rheumatoid factor(RF)were detected and compared among groups for their diagnostic efficiency.Results The positivity rates of serum anti-CEP-1 antibody,anti-CCP antibody,AKA,APF and RF were significantly higher in the RA group than those in the non-RA and control groups(P<0.05).In RA patients,anti-CEP-1 yielded significantly higher sensitivity than AKA and APF,as well as significantly higher accuracy than AKA,APF and RF,with statistically significant differences(all P<0.05).The positivity rates of serum anti-CEP-1 antibodyin RA patients who tested negative for anti-CCP antibody,AKA,APF,ACPA,RF and in those who tested dual-negative for ACPA and RF were 34%,49%,47%,30%,38%and 22%,respectively.Conclusion Anti-CEP-1 antibody has a high diagnostic yield in RA patients,and when combined with other autoantibody testing,would help improve the diagnostic efficiency of RA.