CDFI血流信号分级、抗CCP抗体、G6PI、RF对类风湿性关节炎的诊断价值

Diagnostic value of CDFI blood flow signal grade,anti-CCP antibody,G6PI,and RF combined detection in rheumatoid arthritis

目的分析彩色多普勒血流显像(CDFI)血流信号分级、抗环瓜氨酸肽抗体(CCP)、葡萄糖6磷酸异构酶(G6PI)、类风湿因子(RF)对类风湿性关节炎(RA)的诊断价值。方法回顾性选取2022年4月至2023年10月新疆医科大学附属中医医院收治的100例RA患者纳入观察组,根据病情分为RA活动期组(n=50)和RA非活动期组(n=50);依据血流信号CDFI分级分为0~1级组(n=20)、2级组(n=17)、3级组(n=13)。选取同期本院收治的100例其他自身免疫性疾病患者纳入对照组。比较观察组、对照组一般临床资料(性别、病程、年龄、RA家族史、体重指数、吸烟史、饮酒史、居住地、职业等),比较不同活动期患者抗CCP抗体、G6PI及RF水平;比较不同血流信号分级组患者抗CCP抗体、G6PI及RF水平;采用受试者工作特征(ROC)曲线评估CDFI血流信号分级、抗CCP抗体、G6PI、RF联合检测对RA的诊断价值。结果两组患者性别构成比、病程、年龄、RA家族史、体重指数、吸烟史、饮酒史、居住地、职业比较,差异均无统计学意义(P>0.05);观察组患者抗CCP抗体、G6PI及RF水平均高于对照组,差异均有统计学意义(P<0.05)。RA活动期组患者抗CCP抗体、G6PI及RF水平均高于RA非活动期组患者,差异均有统计学意义(P<0.05)。血流信号3级组患者抗CCP抗体、G6PI及RF水平均高于血流信号0-1级组、2级组患者,差异均有统计学意义(P<0.05)。CDFI血流信号分级、抗CCP抗体、G6PI、RF单独检测RA的敏感度分别为79.57%、86.45%、82.14%、77.89%,特异度分别为83.89%、79.28%、83.67%、84.15%,AUC分别为0.855(0.804~0.907)、0.940(905~0.976)、0.893(0.852~0.935)、0.800(0.736~0.864),CDFI血流信号分级、抗CCP抗体、G6PI、RF联合检测RA的敏感度为89.36%,特异度为77.24%,AUC为0.957(0.933~0.980)。结论RA患者血清CCP抗体、G6PI、RF水平升高,随着CDFI血流信号分级增大,升高愈加明显,CDFI血流信号分级、抗CCP抗体、G6PI、RF联合检测RA诊断价值较高,对判断RA进展具有意义。

Objective To analyze the diagnostic value of color Doppler flow imaging(CDFI)flow signal grading,anti-cyclic citrullinated peptide antibody(CCP),glucose 6 phosphate isomerase(G6PI)and rheumatoid factor(RF)in rheumatoid arthritis(RA).Methods A total of 100 RA patients admitted to Affiliated Hospital of Traditional Chinese Medicine,Xinjiang Medical University from April 2022 to October 2023 were included into the observation group and divided into RA active group(n=50)and RA inactive group(n=50),and 0-1 group(n=20),2 group(n=17)and 3 group(n=13)according to the flow signal CDFI.One hundred cases of patients with other autoimmune diseases admitted to our hospital in the same period were included in the control group.The general clinical data(gender,disease course,age,RA family history,body mass index,smoking history,drinking history,place of residence,occupation,etc)of observation and control groups were compared to compare the anti-CCP antibody,G6PI and RF levels in patients with different active periods,and the anti-CCP antibody,G6PI and RF levels in patients with different blood flow signal grading groups.The diagnostic value of CDFI blood flow signal grading,anti CCP antibodies,G6PI,and RF combined detection for RA was evaluated using receiver operating characteristic(ROC)curves.Results There were no statistically significant differences between the two groups in terms of gender composition ratio,disease duration,age,RA family history,body mass index,smoking history,drinking history,place of residence,and occupation(P>0.05);the levels of anti CCP antibodies,G6PI,and RF in the observation group were higher than those in the control group,and the differences were statistically significant(P<0.05).The levels of anti CCP antibodies,G6PI,and RF in the RA active group than those in RA inactive group,and the differences were statistically significant(P<0.05).The levels of anti CCP antibodies,G6PI,and RF in patients with blood flow signal level 3 were higher than those in patients with blood flow signal level 0-1 and level 2,and the differences were statistically significant(P<0.05).The sensitivity of CDFI flow signal grade,anti-CCP antibody,G6PI,and RF alone was 79.57%,86.45%,82.14%,77.89%,respectively,the arities were 83.89%,79.28%,83.67%,84.15%,respectively,AUC was 0.855(0.804-0.907),0.940(905-0.976),0.893(0.852-0.935),0.800(0.736-0.864),respectively,the sensitivity of the CDFI blood flow signal grade,anti-CCP antibody,G6PI,and RF combination for detecting rheumatoid arthritis was 89.36%,the specificity was 77.24%,the AUC was 0.957(0.933-0.980).Conclusion The serum CCP antibody,G6PI and RF levels increased in rheumatoid arthritis patients,and with the increase of CDFI flow signal grade,the increase became more obvious.The diagnostic value of CDFI flow signal grade,anti-CCP antibody,G6PI and RF,which is of significance to judging the progression of rheumatoid arthritis.