类风湿因子、AKA和抗CCP抗体检测在类风湿关节炎的诊断价值  

Value of dentection of anti-CGP and rheumatoid factors AKA in diagnosis of rheumatoid arthritis

作　　者：符克英[1] 陈汝[1] 占锋[1] 钟路[1] 

机构地区：[1]海南省人民医院,海南海口570311

出　　处：《中国热带医学》2007年第11期2029-2030,2068,共3页China Tropical Medicine

摘　　要：目的检测类风湿关节炎(RA)患者血清中的类风湿因子(RF-IgG、RF-IgA、RF-IgM)、抗角蛋白抗体(AKA)和抗环瓜氨酸肽抗体(抗CCP),探索其对RA的诊断价值。方法对70例RA患者、114例非RF的风湿免疫病患者血清同时进行测定了RF(ELISA法)、AKA(间接免疫荧光法)和抗CCP(ELISA法),并对三者之间检测的一致性进行了分析。结果RF-IgG,RF-IgA,RF-IgM,AKA和抗CCP对RA的敏感性分别为14.3%(10/70)、45.7%(32/70)、74.3%(52/70)、42.8%(30/70)和65.7%(46/70),特异性分别为96.5%、91.2%、83.3%、98.2%和97.3%。联合检测2种抗体、3种抗体和5种抗体,敏感性及特异性分别是RF-IgA+RF-IgM为45.7%和92.9%,RF-IgG,+RF-IgA+RF-IgM为14.3%和96.5%,RF-IgA+RF-IgM+AKA为42.8%和99.1%,RF-IgA+RF-IgM+抗CCP抗体为45.7%和99.1%,RF-IgG,+RF-IgA+RF-IgM+AKA+抗CCP抗体为12.9%和100%。结论抗CCP抗体和AKA单独检测对RA具有高度的特异性,敏感性抗CCP抗体比AKA略高;单独检测RF-IgM敏感性最高,但特异性最低;RF与AKA、抗CCP联合检测可进一步提高对RA诊断的特异性。Objective To detect the rheumatoid factor antibodies（RF- IgG, RF- IgA, RF- IgM）, anti - AKA and anti - CCP in patients with rheumatoid arthritis（RA） and probe into their diagnostic value. Methods Rheumatoid factor were detected by ELISA, anti- AKA was detected by IIF and anti - CCP was detected by ELISA simultaneously in 70 RA patients and 114 patients with other rheumatic disease. Results The sensitivity of RF- IgG, RF- IgA, RF - IgM, anti - AKA and anti - CCP were 14. 3%（10/70）, 45.7% （32/70）, 74.3% （52/70）, 42.8% （30/70）, 65.7% （46/70） and the specificity were 96.5%, 91.2%, 83,3%, 98.2%, 97.3%. The sensitivity and specificitiy of combined detection of IgA and IgM were 45.7% and 92.9%, that of combined detection of IgG, IgA and IgM were 14.3% and 96.5%, that combined detection of IgA, IgM and anti - AKA were 42. 8% and 99.1%, that of combined detection of IgA, IgM and anti - CCP were 45.7% and 99.1% and that of combined detection of IgG, IgA, IgM, anti - AKA and anti- CCP were 12.9 % and 100 %. Conclusion The specificity of separate detection of anti - CCP and AKA in RA is higher. The sensitivity in detecting anti - CCP than that detecting AKA. The specificity of diagnosis of RA can be enhanced by joint detection of anti - AKA and anti - CCP.

关 键 词：类风湿性关节炎 抗CCP抗体 抗角蛋白抗体(AKA) 类风湿因子(RF-IgG、RF-IgA、RF-IgM) 

分 类 号：R593.22[医药卫生—内科学]