血清抗CCP抗体、GPI、HLA-DR4联合检测对类风湿关节炎的诊断价值

Diagnostic value of combined detection of serum anti CCP antibody,GPI and HLA-DR4 in rheumatoid arthritis

目的探讨血清抗环瓜氨酸肽抗体(抗CCP抗体)、葡萄糖-6-磷酸酶(GPI)、人类白细胞抗原-DR4(HLA-DR4)联合检测对类风湿关节炎(RA)的诊断价值。方法选取2015年6月至2017年5月该院收治的82例RA患者作为RA组,选取同期该院收治的82例非RA患者为非RA组,以及80例健康体检者作为对照组。比较3组研究对象血清抗CCP抗体、GPI、HLA-DR4阳性率、3项指标单独及联合检测对RA的诊断价值。结果 RA组患者血清抗CCP抗体、GPI、HLA-DR4阳性率显著高于非RA组和对照组(P<0.05)。抗CCP抗体、GPI、HLA-DR4单独检测时,以GPI的灵敏度最高(78.6%),抗CCP抗体的特异度最高(97.5%),差异均有统计学意义(P<0.05)。在联合检测中,以抗CCP抗体、GPI、HLA-DR4三者联合检测的灵敏度和特异度最高(90.5%,97.5%),差异有统计学意义(P<0.05)。结论血清抗CCP抗体、GPI、HLA-DR4联合检测可以提高对RA诊断的灵敏度和特异度,有效减少漏诊、误诊的发生。

Objective To investigate diagnostic value of combined detection of serum anti-cyclic citrullinated peptide antibody(anti CCP antibody),glucose-6-phosphatase(GPI)and human leucocyte antigen-DR4(HLA-DR4)in rheumatoid arthritis.Methods From June 2015to May 2017,82patients with rheumatoid arthritis(RA)were selected as the RA group,82non RA patients and 80healthy subjects were selected as non RA group and control group in the same period.The serum anti CCP antibody,GPI,HLA-DR4positive rate and diagnostic criteria of three indicators of RA were compared between the three groups.Results The positive rates of serum anti CCP antibody,GPI and HLA-DR4in RA group were significantly higher than that in non RA group and control group(P<0.05).Among the three indexes of anti CCP antibody,GPI and HLADR4,the sensitivity of GPI was the highest(78.6%),and the specificity of anti CCP antibody was the highest(97.5%).Differences were statistically significance(P<0.05).In joint detection,the sensitivity(90.5%)and specificity(97.5%)of combined detection of anti CCP antibody,GPI and HLA-DR4were the highest,differences were statistically significance(P<0.05).Conclusion The combined detection of serum anti CCP antibody,GPI and HLA-DR4could improve the sensitivity and specificity of RA diagnosis,and effectively reduce the misdiagnosis and missed diagnosis.