血清ACCP在HCV感染并发冷球蛋白血症的诊断价值  

Diagnostic values of sera antibodies to cyclic citrullinated peptide in patients with hepatitis C virus infection complicated with mixed cryoglobulinemia

作　　者：余文辉[1] 周小梅[1] 周大桥[2] 张剑勇[3] 邓敏茹 陈佩莹[4] 

机构地区：[1]广东省深圳市中医院检验科,518033 [2]广东省深圳市中医院国家级肝病重点专科,518033 [3]广东省深圳市中医院风湿科,518033 [4]汕头市第二人民医院检验科,515011

出　　处：《国外医学（临床生物化学与检验学分册）》2005年第10期681-683,共3页Foreign Medical Sciences(section of Clinical Biochemistry and Laboratory Medicine

摘　　要：目的探讨血清抗环瓜氨酸肽抗体(ACCP)在丙型肝炎病毒(HCV)感染并发冷球蛋白血症中的诊断价值。方法收集HCV感染患者20例、HCV感染伴冷球蛋白血症患者5例、混合型冷球蛋白血症(MC)患者5例和健康献血者20例,分别用酶联免疫吸附试验(ELISA)和比浊法测定其血清ACCP和类风湿因子(RF)水平。结果20例HCV感染患者,血清ACCP试验均为阴性,最大值为10U。其中9例(45%)RF>15U/ml,3例(15%)RF>50 U/ml,最高者RF为526 U/ml。HCV感染伴冷球蛋白血症患者5例中,3例(60%)血清ACCP试验为阳性,均值为47U;混合型冷球蛋白血症患者5例中,4例(80%)RF试验阳性,其中3例(60%)RF>50 U/ml,最大值为540 U/ml;1例(20%)冷球蛋白血症患者ACCP试验呈临界值阳性结果(25U)。20例健康献血者血清ACCP和RF试验均为阴性。结论ACCP检测有助于慢性HCV感染并发冷球蛋白血症患者的早期诊断。Objective To investigate the diagnostic values of sera antibodies to cyclic citrullinated peptide （ACCP） in patients with hepatitis C virus （HCV） infection complicated with mixed cryoglobulinemia （MC）. Methods Rheumatoid factor （RF） and ACCP were measured in sera from 20 patients with HCV infection but Without cryoglobulinemia, 5 patients with HCV infection complicated with cryoglobulinemia,sera from 5 patients with MC, and sera from 20 healthy blood donors. ACCP was measured by second generation enzyme-linked immunosorbent assay（ELISA）, RF were measured using nephelometer. Results No sera with elevated ACCP were found in 20 patients with HCV infection,and in that population,the maximum ACCP was 10 units （U）. Positive findings on RF testing 15 U/ml were present in 9 cases（45 % ） of the HCV patients, with RF2〉 50 U/ml in 3 cases （15 %） and a maximum RF of 526 U/ml. Sera ACCP levels elevated were found in 3 of 5 patients with HCV infection complicated with cryoglobulinemia, the mean of ACCP was 47 U. Of the 5 MC patients, 4 cases （75%） had positive results on tests for RF,including 3 cases （60%） with RF〉50 U/ml and a maximum RF of 540 U/mL . One （20%） of the 5 MC patients had borderline positive results on tests for ACCP （ 25 U）. Sera ACCP and RF testing were negative in 20 healthy donors. Conclusion Measurement of ACCP may help to diagnose early MC in patients with chronic HCV infection.

关 键 词：抗环瓜氨酸肽抗体 类风湿因子 冷球蛋白血症 肝炎病毒 丙型 

分 类 号：R512.6[医药卫生—内科学]