类风湿因子阴性类风湿关节炎的临床诊断研究  

Clinical Diagnostic Research on RF-negative and the Positive Diagnosis of Rheumatoid Arthritis

作　　者：靳启国[1] 师建成[1] 周方[1] 

机构地区：[1]山东中医药大学第二附属医院,济南250001

出　　处：《临床误诊误治》2007年第10期3-5,共3页Clinical Misdiagnosis & Mistherapy

摘　　要：目的:研究4种自身抗体及影像学检查对类风湿因子(RF)阴性类风湿关节炎(RA)的临床诊断价值。方法:选择260例RF阳性和252例RF阴性RA患者,分别进行血清学抗核周因子(APF)、抗角蛋白抗体(AKA)、抗RA33抗体、抗Sa抗体检测和MRI、X线检查,应用统计学方法对两组各项指标的阳性率及RA检出率进行比较。结果:RF阳性组APF、AKA、抗RA33抗体、抗Sa抗体阳性率分别为73.08%、72.69%、48.85%、47.69%;RF阴性组阳性率分别为69.84%、68.65%、54.76%、42.86%,两组差异无显著性意义(P>0.05);MRI、X线检查对RF阳性组和RF阴性组的检出率均为100.00%,两组差异无显著性意义(P>0.05)。结论:APF、AKA、抗RA33抗体、抗Sa抗体检测对诊断RF阴性RA具有较高敏感性和特异性,将上述抗体选择性的与RF进行联合检测,在一定程度上可弥补RF对RA诊断的不足。此外,X线和MRI检查对发现RA相关骨与关节损害均较灵敏。Objective：To study the clinical diagnostic value of 4 methods of autoantibody and imageology in rheumatoid factor （RF）-negative patients with rheumatoid arthritis （RA）. Methods：260 cases with RA and RF-positive and 252 cases with RF- negative RA, serological anti-nuclear factor （APF） ,anti-keratin antibody （AKA） , anti-RA33 antibody,anti-Sa antibody detection and MRI,X-ray inspection,the application of statistical methods in the two groups indicating positive rate and RA detection rate were statistically compared. Results： RF-positive group, APF, AKA, anti-RA33, anti-Sa antibody positive rate were 73.08% , 72.69% ,48.85% ,47.69% ;RF-negative RA positive rate were 69.84% ,68.65% ,54.76% ,42.86%. Difference between the two groups was not statistically significant （P 〉 0. 05） ; MR, X-ray examination of RF-positive group and RF-negative group was found in 100% , with no significant difference between the two groups （ P 〉 0. 05 ）. Conclusion ： APF, AKA, anti-RA33, anti-Sa antibodies in the diagnosis of RF-negative RA with RF-positive RA with the same sensitivity and specificity of clinical selective detection, as laboratory diagnosis of RA indicators ,to a certain extent, compensate for RF and RA diagnosis of the deficiencies. Besides,X-ray and MRI examinations are comparatively sensitive to detect bone and joint damage.

关 键 词：关节炎 类风湿 血清学试验 抗体 

分 类 号：R593.22[医药卫生—内科学]