摘要
目的探讨抗环瓜氨酸肽抗体(抗CCP抗体)及3种血清型类风湿因子(RF)Ig M-RF、Ig G-RF、Ig A-RF联合检测在类风湿性关节炎(RA)诊断中的应用价值。方法采用酶联免疫吸附试验(ELISA)对60例RA患者及55例非RA患者的血清进行抗CCP抗体、Ig M-RF、Ig G-RF、Ig A-RF检测,并结合其RF、免疫球蛋白、补体、CRP、ESR、血常规及临床指标进行统计学分析。结果 RA组患者抗CCP抗体及3种血清型RF的阳性率均显著高于非RA组,差异有统计学意义(P<0.01);单项检测抗CCP抗体、Ig M-RF、Ig G-RF、Ig A-RF对RA的敏感性和特异性分别为78.3%、83.3%、70%、65%和94.9%、76.4%、81.8%、78.2%;联合检测对RA的敏感性和特异性分别是:Ig M-RF+Ig G-RF为53.5%、81.8%;Ig M-RF+Ig A-RF为46.7%、87.3%;抗CCP抗体+Ig M-RF为56.7%、96.4%;Ig M-RF+Ig GRF+Ig A-RF为43.3%、90.9%;Ig M-RF+Ig G-RF+抗CCP抗体为38.3%、96.4%;Ig M-RF+Ig G-RF+Ig A-RF+抗CCP抗体为20%、100%;抗CCP抗体阳性和阴性患者在ESR、RF滴度值和晨僵方面的差异具有统计学意义(P<0.05)。结论抗CCP抗体对RA的诊断价值优于Ig M-RF、Ig G-RF、Ig A-RF;抗CCP抗体在一定程度上可能有助于RA的病情判断和活动性的监测;4项指标联合检测可进一步提高对RA的诊断特异性。
Objective To evaluate the diagnostic value of the combination of anti - cyclic citrllinated peptide antibody （ anti - CCP）, IgM - rheumatoid factor （ RF）, IgG - RF and IgA - RF in the patients with rheumatoid arthritis （RA）. Methods Among 60 cases with RA and 55 cases without RA, anti - CCP, IgM - RF, IgG - RF and IgA - RF were detected by enzyme - linked immunosor- bent assay （ELISA） and analyzed with SPSSI 3.0 software. Results The positive rates of IgM - RF, IgG - RF, IgA - RF and anti - CCP in RA group were higher than those of the autoimmune disease group （P 〈0. 01 ）. The sensitivity of anti- CCP, IgM -RF, IgG - RF and IgA - RF were 78.3%, 83.3%, 70% and 65% respectively, while the specificity of anti - CCP, IgM - RF, IgG - RF and IgA - RF were 94. 9%, 76. 4% , 81.8% and 78.2% respectively. The sensitivity and specificity of IgM - RF and IgG - RF through the combined detection were 53.5% and 81.8%, those of IgM - RF and IgA - RF were 46. 7% and 87.3%, anti - CCP and IgM - RF were 56. 7% and 96. 4% , IgM - RF, IgG - RF and IgA - RF were 43.3% and 90. 9% , IgM - RF, IgG - RF and anti - CCP were 38.3% and 96. 4%, IgM - RF, IgG - RF, IgA - RF and anti - CCP were 20% and 100%. There were significant differences （P 〈 O. 05 ） in RF titer values, ESR and morning stiffness between anti - CCP antibody positive and anti - CCP antibody negative patients. Conclusion Anti - CCP antibodies in the diagnosis of RA are superior to IgM - RF, IgG - RF and IgA - RF. Anti - CCP antibody to a certain extent may contribute to the judgment and monitoring of the disease. The specificity of diagnosis of RA can be enhanced by joint detection of anti - CCP, IgM - RF, IgG - RF and IgA - RF.
出处
《辽宁医学院学报》
CAS
2015年第5期43-46,共4页
Journal of Liaoning Medical University (LNMU) Bimonthly
关键词
抗环瓜氨酸肽抗体
类风湿因子
类风湿性关节炎
anti -cyclic citrullinated peptide antibody
rheumatoid factor
rheumatoid arthritis
