抗CCP抗体和抗MCV抗体对类风湿性关节炎诊断价值的评价

Evaluation of diagnostic value of Anti-CCP Antibody and Anti-MCV antibody to rheumatoid arthritis

目的探讨抗环瓜氨酸肽抗体(抗CCP抗体)和抗突变型瓜氨酸波形蛋白抗体(抗MCV抗体)在类风湿性关节炎(RA)诊断中的价值.方法回顾性分析南京医科大学附属无锡人民医院风湿科217例(RA患者组142例,非RA的风湿科疾病对照组75例)抗CCP抗体和抗MCV抗体的检测结果,计算抗CCP抗体和抗MCV抗体对于诊断RA疾病的灵敏度、特异度、阳性预测值、阴性预测值和总符合率.结果142例RA患者中,35例RA低度活动组抗CCP抗体和抗MCV抗体阳性检出率分别为71.4%(25/35)、71.4%(25/35);50例RA中度活动组抗CCP抗体和抗MCV抗体阳性检出率分别为94.0%(47/50)和90.0%(45/50),57例RA重度活动组抗CCP抗体阳性检出率为98.2%(56/57),抗MCV抗体阳性检出率为100%(57/57).75例非RA的风湿科疾病对照组抗CCP抗体和抗MCV抗体阳性检出率分别为2.7%和5.3%.抗CCP抗体对于RA的诊断灵敏度、特异度、阳性预测值、阴性预测值分别为90.1%、97.3%、98.5%、83.9%,相应的抗MCV抗体的指标分别为89.4%、94.7%、96.2%、83.5%.二者检测结果的总符合率分别为92.6%(201/217)、92.2%(200/217).结论抗CCP抗体、抗MCV抗体在RA的实验室诊断中都具有非常高的灵敏度和特异度,二者诊断价值相近,适合各级医院选择推广.

Objective To investigate the values of anti-cyclic citrullinate peptide antibody(anti-CCP antibody)and anti-mutant citrulline vimentin antibody(anti-MCV antibody)in the diagnosis of rheumatoid arthritis(RA).Methods The detection results of anti-CCP antibody and anti-MCV antibody in 217(142 RA patients,75 non-RA patients)cases of rheumatology in our hospital were retrospectively analyzed.The sensitivities,specificities,positive predictive values,negative predictive values and total concordant rates of anti-CCP antibody and anti-MCV antibody for the diagnosis of RA were calculated.Results Among 142 RA patients,the positive rates of anti-CCP antibody and anti-MCV antibody in 35 lowpatients activity group were 71.4%(25/35)and 71.4%(25/35).The positive rates of anti-CCP antibody and anti-MCV antibody in 50 patients with moderate activity group were 94.0%(47/50)and 90.0%(45/50),respectively.The positive rates of anti-CCP antibody and anti-MCV antibody in 57 patients with severe activity group were 98.2%(56/57)and 100%(57/57),respectively.The positive rates of anti-CCP antibody and anti-MCV antibody were 2.7%and 5.3%,respectively,in 75 patients with non-RA group.The sensitivity,specificity,positive predictive value and negative predictive value of anti-CCP antibody for the diagnosis of RA were 90.1%,97.3%,98.5%and 83.9%,and the corresponding values of anti-MCV antibody were 89.4%,94.7%,96.2%and 83.5%,respectively.The total coincidence rates of the two detection results were 92.6%(201/217)and 92.2%(200/217),respectively.Conclusion Both anti-CCP antibody and anti-MCV antibody have very high sensitivities and specificities in the laboratory diagnosis of RA,and they have similar diagnostic values,so they are suitable for selection and promotion in hospitals at all levels.