抗环瓜氨酸肽抗体及相关自身抗体在类风湿性关节炎诊断中的应用评价  

Evaluation of anti-cyclic citrullinated peptide antibody and other correlated antibodies in diagnosing rheumatoid arthritis

作　　者：张建明[1] 丁玲华[1] 金跃[1] 葛志中 

机构地区：[1]徐州医学院附属淮安医院,江苏淮安223002 [2]解放军第82医院

出　　处：《中国实验诊断学》2004年第5期513-516,共4页Chinese Journal of Laboratory Diagnosis

摘　　要：目的　评价抗环瓜氨酸肽 (CCP)抗体及其相关自身抗体对诊断类风湿性关节炎 (RA)的敏感性和特异性以及在临床上的意义。方法　收集 112例血清标本 ,包括RA 6 4例 ,系统性红斑狼疮 (SLE) 2 0例 ,骨关节炎 (OA) 16例 ,强直性脊柱炎 (AS) 12例 ,正常对照 30例 ,检测抗CCP、抗Sa、抗核周因子 (APF)和类风湿因子 (RF)。结果　 4种自身抗体对诊断RA的敏感性和特异性分别为 :抗CCP 5 1 6 %和 97 9% ;抗Sa 4 6 9%和 10 0 % ;APF 4 8 4 %和 97 9% ;RF 5 6 3%和 83 3% ;敏感性无显著性差异 (P >0 0 5 ) ,抗CCP、抗Sa和APF诊断RA特异性无显著性差异 (P >0 0 5 ) ,但三者均高于RF(P <0 0 1)。RF阳性率在RA患者抗CCP阳性组和阴性组有显著性差异 (P <0 0 1)。而抗Sa和APF则无显著性差异 (P >0 0 5 )。结论　抗CCP是RA的又一个特异性抗体 ,联合检测抗CCP及RF对于RA的诊断与早期诊断具有一定的临床价值。Objective To evaluation the sensitivity and specificity of anti-cyclic citrullinated peptide(CCP) antibody and some associated auto-antibodies in RA and its clinical significance. Methods Anti-CCP, anti-Sa, APF and RF were deteced in 112 sera including 64 RA, 20 SLE, 16 OA, 12 As and 30 health controls. Results The sensitivity and specificity in diagnosing RA is:anti-CCP 51 6% and 97 9%, anti-Sa 46 9% and 100%, APF 48 4% and 97 9%, RF 56 3% and 83 3%, respectively. There is no statistical difference for the sensitivity( P >0 05), The specificity of anti-CCP, anti-Sa and APF There is no statistical difference( P >0 05), but its is higher than RF( P <0 01). RF positive rate has a statistical difference between anti-CCP-positive and anti-CCP-negative RA( P <0 01), but the positive results of anti-Sa and APF is nearly the same( P >0 05). Conclusion anti-CCP is another serologic marker for RA patients. It is important to detect anti-CCP and RF together in diagnosing RA at early stage.

关 键 词：类风湿性关节炎 抗环瓜氨酸肽抗体 抗SA抗体 抗核周因子 

分 类 号：R593.22[医药卫生—内科学]