免疫学检验联合检测在类风湿关节炎诊断中的应用

Application of Combined Immunologic Tests in the Diagnosis of Rheumatoid Arthritis

目的:观察免疫学检验联合检测在类风湿关节炎诊断中的应用价值。方法:选取2022年2月—2023年2月贵州省六盘水市人民医院收治的类风湿性关节炎患者33例为观察组,选取同期其他疾病患者33例为对照组。所有患者进行免疫学检验,观察两组检验结果差异及免疫学指标联合诊断类风湿性关节炎价值。结果:观察组类风湿因子(RF)阳性率、抗环瓜氨酸肽抗体(抗-CCP)阳性率高于对照组,免疫球蛋白G(IgG)水平高于对照组,补体C3、补体C4水平低于对照组,差异有统计学意义(P<0.001);绘制受试者工作特征(ROC)曲线结果显示,当RF≥20 IU/mL、抗-CCP≥20 AU/mL、IgG>17.56 g/L、补体C3<0.82 g/L、补体C4<0.34 g/L时,联合诊断符合率95.45%、灵敏度93.94%、特异度96.97%、ROC曲线下面积0.909、95%CI 0.865~0.997,高于单一指标诊断,差异有统计学意义(P<0.05)。结论:类风湿关节炎患者抗-CCP、IgG、RF水平较高,补体C3、补体C4水平较低,类风湿关节炎诊断中抗-CCP、IgG、RF、补体C3、补体C4联合应用可以提高诊断准确性,规避误诊、漏诊等情况。

Objective:To observe the application value of combined immunologic tests in the diagnosis of rheumatoid arthritis.Methods:Thirty-three patients with rheumatoid arthritis admitted to Guizhou Liupanshui People's Hospital from February 2022 to February 2023 were selected as the observation group,and thirty-three patients with other diseases during the same period were selected as the control group.All patients were subjected to immunological tests to observe the differences between the test results of the two groups and the value of immunological indicators in the joint diagnosis of rheumatoid arthritis.Results:The positive rate of rheumatoid factor(RF)and anti-cyclic citrullinated peptide antibody(anti-CCP)in the observation group was higher than that in the control group,the level of immunoglobulin G(IgG)was higher than that in the control group,and the level of complement C3 and complement C4 was lower than that in the control group,and the difference was statistically significant(P<0.001);The results of plotting the working characteristic curve(ROC)of the subjects showed that when RF≥20 IU/mL,anti-CCP≥20 AU/mL,IgG>17.56 g/L,complement C3<0.82 g/L,complement C4<0.34 g/L,the compliance rate of combined diagnosis was 95.45%,sensitivity 93.94%,specificity 96.97%,and area under the ROC curve 0.909,95%CI 0.865-0.997,which was higher than the diagnosis of single index,and the difference was statistically significant(P<0.05).Conclusion:Anti-CCP,IgG,RF levels were higher and complement C3,complement C4 levels were lower in patients with rheumatoid arthritis,and the combined application of anti-CCP,IgG,RF,complement C3,complement C4 in the diagnosis of rheumatoid arthritis can improve the diagnostic accuracy and circumvent misdiagnosis and missed diagnosis.