抗环瓜氨酸肽抗体在类风湿性关节炎诊断中的应用

Diagnostic value of anti-cyclic citrullinated peptide antibody in patients with rheumatoid arthritis

目的 探讨抗环瓜氨酸肽 (CCP)抗体检测在类风湿性关节炎 (RA)诊断中的意义。方法 根据cDNA序列人工合成的CCP为抗原 ,用ELISA方法检测 2 18例 (RA 112例 ,非RA 76例及正常人 30例 )血清中的抗CCP抗体 ,并比较抗CCP抗体与类风湿因子 (RF)的相关性。结果 抗CCP抗体在RA组患者血清中的阳性率 4 9.1% ,明显高于非RA组 ( 3.94 % )和正常对照组 ( 0 .0 % ) ,经 χ2 检验P <0 .0 5。抗CCP抗体对诊断RA的敏感性和特异性分别为 4 9.1%、96 .1% ,阳性预测值和阴性预测值为 94 .8%、4 3.8%。在 112例确诊为RA患者的血清中抗CCP抗体与RF重叠阳性率为 85 .4 % ,两者含量呈正相关。结论 抗CCP抗体对RA具有很高的特异性 。

Objective To explore the significance of CCP antibody in the diagnosis of rheumatoid arthritis. Methods The synthesized CCP deduced from the known cDNA sequence was used as antigen in ELISA, Sera of 218 patients were tested by enzyme linked immunosorbent assay. 112 cases were rheumatoid arthritis,76 cases were non rheumatoid arthritis and 30 normal cases were designated as controls then, the relativity between antibody against CCP and RF was compared. Results The positive rate of antibody against CCP of the RA group was 49.1% and was significantly higher than that of the non RA group(3.94%) and that of the control group(0.0%, P <0.05). The sensitivity and spe cificity were 49.1%,96.1% respe ctively. The positive predict value and negative predict value were 94.8%,43.8% respectively. The cross positive of CCP antibody and RF in RA group was 85.4%. Their quantity was positively related. Conclusions The CCP antibody has very high specificity and might be used as a valuable parameter in the diagnosis of rheumatoid arthritis.