联合检测AFA与抗CCP抗体RF对评估类风湿关节炎的临床意义  

Clinical Significance of Combined Detection of AFA,Anti-CCP Antibody and RF in Rheumatoid Arthritis

作　　者：肖镇[1] 白丽杰[1] 秦毅强[1] 

机构地区：[1]内蒙古医学院附属医院风湿科,内蒙古呼和浩特010050

出　　处：《内蒙古医学杂志》2006年第1期9-12,共4页Inner Mongolia Medical Journal

摘　　要：目的：①检测类风湿关节炎（RA）患者血清抗聚角蛋白微丝蛋白抗体（AFA）、抗环瓜氨酸肽（CCP）抗体及类风湿因子（RF），比较单独检测和联合检测对RA诊断的敏感性，特异性，阳性预测值。②比较AFA、抗CCP抗体阳性组与阴性组间关节指数、晨僵时间，血沉（ESR）、C反应蛋白（CRP），X线骨侵蚀之间的关系。③分析引起骨侵蚀的危险因素。方法：RA组92例血清标本来自2003年10月～2005年1月就诊于内蒙古医学院附属医院内科门诊及住院患者。AFA、抗CCP抗体用酶联免疫吸附法（ELISA），RF、CRP用液相终点散射沉淀法。结果：①AFA、抗CCP抗体阳性率与对照组有统计学意义（P〈0．05）。②AFA、抗CCP抗体、RF联合检测的敏感性降低，特异性、阳性预测值较单独检测明显升高（P〈0．05）。③AFA、抗CCP抗体阳性组病情活动指标与阴性对照组差异有统计学意义（P〈0．05），抗CCP抗体阳性是RA发生骨侵蚀的危险因素之一。结论：抗CCP抗体、AFA有共同的抗原决定簇，存在相关性，但不完全重叠。临床上与RF联合检测有助于提高RA的早期诊断、预测病情的活动性及严重程度。具有广泛的临床应用前景。Objective： ①To detect the levels of serum antifilaggrin antibody（AFA）, anti - cyclic citrullinated peptide antibody（anti- CCP） and rheumatoid factor（RF） in patients with rheumatoid arthritis（RA）, and compare the sensitivity, specificity and positive predictive value of diagnosis in RA between respective detection and combined detection. ②To compare the articulus index, time of morning stiffness,erythrocyte sedimentation rate, C - reactive protein and time of bone erosion between group with positive AFA, anti - CPP and group with negative ones. ③To analyze risk factors inducing bone erosion. Methods： Serum specimens of 92 patients with RA were collected from Oct. 2003 to Jan. 2005. The levels of AFA and anti - CCP antibody were detected by ELISA method,that of RF and CRP by liquid-phase immunoprecipitation assay with luplulometric end- point detection. Results：①There was statistical difference in positive rate of AFA and anti- CCP antibody between RA group and control group（P〈 0.05）. ②The sensitivity of combined detection of AFA, anti- CCP antibody and RF was decreased, but the specificity and positive predictive value of combined detection of above parameters was increased than that of respective detection（P〈 0.05）. ③The index of pathogenetic condition showed statistical significance between group with positive AFA and anti - CCP antibody and control group with negative ones（P 〈 0.05）. The positive anti- CCP antibody was one of risk factors for bone erosion in RA. Conclusion：The anti - CCP antibody is correlated with AFA for common antigen determinant, which is not identical. Clinically combined detection of anti- CCP antibody,AFA and RF is helpful to improving the early diagnosis of RA and prognosis in activity and severity of condition, it＇s clinical application should be widespread.

关 键 词：类风湿因子 抗聚角蛋白微丝蛋白抗体 抗环瓜氨酸肽抗体 

分 类 号：R593.22[医药卫生—内科学]