抗环瓜氨酸肽抗体在类风湿关节炎中的诊断意义  

Diagnostic significance of anti-cyclic citrullinated peptide antibody in patients with rheumatoid arthritis

作　　者：严利文[1] 李晶[1] 吴玲[1] 张梅棣[1] 

机构地区：[1]江苏大学附属医院风湿科,江苏镇江212001

出　　处：《江苏大学学报（医学版）》2007年第2期164-166,共3页Journal of Jiangsu University：Medicine Edition

摘　　要：目的:评价抗环瓜氨酸肽抗体(抗CCP抗体)在类风湿关节炎(RA)诊断中的意义及在鉴别类风湿关节炎和其他结缔组织疾病(非RA组)中的意义。方法:对80例RA患者与45例其他结缔组织疾病患者(弥漫性结缔组织病32例、血清阴性脊柱关节病8例、痛风3例、骨性关节炎2例)检测抗CCP抗体(ELISA法),类风湿因子IgM-RF(散射比浊法)。结果:IgM-RF诊断RA的敏感性较抗CCP抗体高(RA 71.3%,抗CCP抗体55%),但抗CCP抗体有更高的诊断特异性(抗CCP抗体91.1%,RF 62.2%)。抗CCP抗体和IgM-RF联合检测特异性(93.3%)高于单独检测IgM-RF(P<0.01)。结论:抗CCP抗体是RA良好的血清学诊断指标,与IgM-RF联合检测可进一步提高诊断的准确性,有助于RA与其他结缔组织疾病的鉴别。Objective： To examine the diagnostic significance of anti-cyclic citrullinated peptide antibody in patients with rheumatoid arthritis and to examine the value of anti-cyclic citrullinated, peptide（CCP） antibodies and rheumatoid factor （RF） in differenting patients with rheumatoid arthritis （RA） from other rheumatic diseases. Methods： It was determined that the concentration of the two markers in 80 RA patients and 45 non-RA patients. Anti-cyclic citrullinated peptide antibodies was conduced by enzyme-linked immunosorbent assay（ELISA）. IgM-RF was conduced by nephelometry. Results： Sensitivity was higher for RF（71.3% ）, followed by anti-CCP antibodies （55%）. Specificity was higher for anti-CCP antibodies （91.1%）, followed by RF（62. 2%）. The combination of anti-CCP and RF had a high specificity （93.3%）. Conclusion： Anti-CCP antibodies was a satisfactory marker for RA. The combination of anti-CCP and RF can raise the diagonostic accuracy. Anti-CCP antibodies was a satisfactory marker in discriminating between RA and other rheumatic diseases.

关 键 词：抗环瓜氨酸肽抗体 类风湿因子 类风湿关节炎 结缔组织疾病 

分 类 号：R593.22[医药卫生—内科学]