摘要
目的探讨抗角蛋白抗体(AKA)、抗核周因子抗体(APF)、抗环瓜氨酸肽抗体(抗-CCP抗体)和类风湿因子(RF)各种亚型联合检测在类风湿关节炎(RA)早期诊断中的应用及意义。方法选择曲靖市第二人民医院就诊的127例RA患者,进行血清AKA、APF抗体、抗-CCP抗体与RF各亚型水平检测,AKA、APF抗体检测采用间接免疫荧光法定性,抗-CCP抗体与RF各亚型水平检测采用酶联免疫吸附试验(ELISA)定量;以同期96例疑似RA的患者为对照。结果 127例RA确诊组中RF(包括IgM、IgG、IgA)阳性116例,阳性率为91.34%;96例RA疑似组中RF(包括IgM、IgG、IgA)阳性47例,阳性率为48.96%;两组比较差异有统计学意义(P<0.01)。RF各亚型出现的阳性率依次为IgA+IgM>IgM>IgM+IgG>IgA+IgM+IgG,与疑似组比较差异无统计学意义(P>0.01);敏感性依次为RF-IgM>CCP>RF-IgA>AKA>APF>RF-IgG,而特异性依次为RF-IgG>APF>AKA>RF-IgA>CCP>RF-IgM。结论 APF、AKA、抗-CCP抗体3种自身抗体对RA具有高度特异性,且在RA早期即可出现;RF-IgM敏感性较高,但特异性较差,多种抗体联合检测有助于RA的早期诊断。
Objective To explore the significance of combined detection of anti-keratin antibody （AKA）, anti-perinuclear factor antibody （APF）, anti-Cyclic citrullinated peptide （CCP） antibody and rheumatoid factor （RF） subtypes in early diagnosis of rheumatoid arthritis （RA） . Methods Detection of The serum levels of AKA, APF, CCP and RF subtypes were detected . AKA, APF antibody was detected by the indirect immunofluorescenee assay and anti-CCP antibody and RF subtypes levels were detected quantitatively by the enzyme-linked immunosorbent assay （ELISA） in 127 patients with RA and 96 patients with suspected-RA . Detection of the serum levels of AKA, APF, CCP and RF subtypes were detected . AKA, APF antibody was detected by the indirect immunofluorescenee assay and anti-CCP antibody and RF subtypes levels were detected quantitatively by the enzyme-linked immunosorbent assay in 127 patients with RA and 96 patients with suspected-RA . Results There were 116 cases of RF （including IgM, IgG, IgA） positive and the positive rate was 91.34% in RA diagnosed group, there were 47 cases of RF （including IgM, IgG, IgA） positive and the positive rate was 48.96% in suspected RA group, there was significant difference between the two groups （P 〈 0.01）. The positive rates was in turn IgA＋IgM 〉 IgM 〉 IgM＋IgG 〉 IgA＋IgM＋IgG in RF subtypes, and there was no significant difference （P 〉 0.01） compared with the suspected group . The order of sensitivity was RF-IgM 〉 CCP 〉 RF-IgA 〉 AKA 〉 APF 〉 RF-IgG, While the order of specificity was RF-IgG 〉 APF 〉 AKA 〉 RF-IgA 〉 CCP 〉 RF-IgM. Conclusions APF antibody, AKA, and anti-CCP antibodies had high specificity and can be detected in early RA. The sensitivity of RF was high, but the specificity was poor, combined detection of multiple antibodies was conducive to early diagnosis of RA.
作者
白志瑶
吕金娥
尹春琼
包艳
冷丽
Bai Zhiyao Lu Jine Yin Chunqiong Bao Yah Leng Li.(Department of Clinical Laboratory, the Second People＇s Hospital of Qujing City, Qujing 655000, Yunnan, Chin)
出处
《实用检验医师杂志》
2017年第1期49-52,共4页
Chinese Journal of Clinical Pathologist
关键词
抗环瓜氨酸肽抗体
抗角蛋白抗体
抗核周因子抗体
类风湿因子及亚型
类风湿关节炎
Anti-Cyclic citrullinated peptide
Anti-keratin antibody antibody
Anti-perinuclear factor antibody
Rheumatoid factor and subtypes
Rheumatoid arthritis
