葡萄糖-6-磷酸异构酶及相关自身抗体诊断类风湿性关节炎的价值  

Value of Glucose-6-phosphate Isomeras and Other Correlated Antibodies in the Diagnosis of Rheumatoid Arthritis

作　　者：张铁汉[1] 许彩青[2] 赵永新[1] 王春燕[3] 王东霞[1] 刘晓军[2] 王伟娟[1] 王伟[1] 

机构地区：[1]新乡医学院第三附属医院检验科,河南新乡453003 [2]新乡医学院第三附属医院风湿肾病科,河南新乡453003 [3]郑州大学第一附属医院肾病风湿科,郑州450052

出　　处：《中国现代医生》2008年第20期3-5,共3页China Modern Doctor

基　　金：河南省教育厅自然科学研究项目(项目批准编号2007320020)

摘　　要：目的探讨葡萄糖-6-磷酸异构酶对类风湿性关节炎的诊断价值,与抗环瓜氨酸肽抗体、类风湿因子之间的相关性以及在临床诊断上的意义。方法对165例RA患者血清和161例非RA患者血清和32例正常人血清用酶联免疫吸附试验、粒子增强免疫透射比浊法进行检测。结果165例RA患者葡萄糖-6-磷酸异构酶敏感度和特异度分别为71.5%和97.9%,与非RA对照组和正常对照组比较差异有显著性(P<0.05);葡萄糖-6-磷酸异构酶与抗CCP抗体和RF重叠阳性率分别为60.6%和57.0%。经统计学分析,葡萄糖-6-磷酸异构酶与抗CCP抗体、RF之间相关性不明显,不完全重叠;三项试验同时检测,以任两项试验阳性为标准诊断RA,则敏感性可提高到77.0%(127/165),特异性97.4%(188/193)。若GPI和抗CCP抗体两项中任一项阳性为标准诊断RA,则敏感性可提高到89.1%,特异性达98.0%。结论葡萄糖-6-磷酸异构酶是协助诊断RA的一个新的实验指标,与抗CCP抗体、RF联合检测能提高RA的早期诊断率。Objective To investigate the value of Glucose-6-phosphate Isomeras（GPI） in the diagnosis of rheumatoid arthritis（RA） and compare the relation of Glueose-6-phosphate isomeras with anti-cyclic eitrullinated peptide （CCP） antibody, and rheumatoid factor （RF）. Methods Serum samples from 165 RA patients and 161 no-RA patients and 32 normal control subjects were tested by enzyme-linked immunosorbent assay（ELISA） and Latex enhanced turbidimetrie immunoassay（LETIA）. Results The sensitivity and specificity of Glueose-6-phosphate isomeras（GPI） in the 165 RA patients were 71.5% and 97.9% respectively,there was significant difference between test group and control group（P〈0.05）; The cross positive rate of Glueose-6-phosphate Isomeras（GPI） with anti - CCP, RF were 60.6% and 57.0% respectively. It was demonstrated that there was less relation between Glueose-6-phosphate isomeras,anti-CCP,RF; when three tests examines simultaneously,take any two tests as the standard to diagnose RA, then the sensitivily was 77.0%（127/165）, specificity 97.4%（188/193）; If taking one of two（GPI and the anti-CCP） positive for the standard to diagnose RA, then the sensitivity may enhance to 89.1%, the specificity reached 98.0%. Conclusion The Glueose-6-phosphate isomeras assay has high sensitivity and good specificity and might be used as a valuable index in the early diagnosis of RA.

关 键 词：葡萄糖-6-磷酸异构酶 抗环瓜氨酸肽 抗体 类风湿性关节炎 酶联免疫吸附试验 

分 类 号：R593.22[医药卫生—内科学]