四项指标联合检测在类风湿关节炎诊断中的应用  

Application of joint detection of four serum indicators in diagnosis of rheumatoid arthritis

作　　者：陆红[1] 夏勇[1] 周蔚[1] 陈延娥[1] 

机构地区：[1]北京大学深圳医院检验科,广东深圳518036

出　　处：《中国热带医学》2009年第1期72-73,共2页China Tropical Medicine

摘　　要：目的探讨抗环瓜氨酸肽抗体(anti-CCP)、葡萄糖-6-磷酸-异构酶抗原(GPI)、抗角蛋白抗体(AKA)、类风湿因子(RF),四项指标联合检测在类风湿关节炎(RA)诊断中的价值。方法对78例RA、86例非RA其他风湿病患者、80名健康志愿者的anti-CCP、GPI、AKA、RF进行检测。结果78例RA患者中anti-CCP、GPI、AKA及RF的灵敏度分别为51.2%(40/78)、42.3%(33/78)、29.5%(23/78)和58.9%(46/78);特异性分别为98.2%(163/166)、98.8%(164/166)、98.2%(163/166)和81.9%(136/166)。86例非RA其他风湿病患者anti-CCP、GPI、AKA及RF的阳性率分别为2.33%(2/86)、2.33%(2/86)、3.49%(3/86)和33.7%(29/86);80名正常对照组中检测到1例抗CCP弱阳性,1例RF阳性,其余指标均为阴性。结论anti-CCP、GPI、AKA对RA诊断灵敏度不高,但均是RA的特异性诊断指标,三者与RF可相互补充,适当的联合检测有助于提高诊断的特异性。Objective To evaluate the clinical value of combined detection of anti-cyclic citrullinated peptide antibody ,glucose-6-phosphate isomerase,anti-keratin antibody and rheumatoid factor for early diagnosis of rheumatoid arthritis. Methods The levels of anti-CCP,GPLAKA,RF in 78 patients with established RA,86 patients with other rheumatic diseases and 80 normal controls were determined. Results The sensitivity of anti-CCP,GPI,AKA and RF in the diagnosing of RA were 51.2%（40/78）, 42.3%（33/78）, 29.5%（23/78） and 58.9% （46/78）,respectively;the specificity were 98.2% （163/166）, 98.8%（164/166）, 98.2%（163/166） and 81.9% （136/166）,respectively.The positive rates of anti-CCP,GPI, AKA and RF in other rheumatic diseases patients were 2.33%（2/86）, 2.33%（2/86）, 3.49%（3/86） and 33.7%（29/86）.There was one faintly positive result of anti-CCP and one positive result of RF in 80 normal controls. Conclusion Though the sensitivity of anti-CCP, GPI, AKA are not high in diagnosis of RA but they are still thespecific indicators and combined detection of these indicators can enhance the specificity in diagtnosis of RA.

关 键 词：类风湿性关节炎 抗环瓜氨酸肽抗体 葡萄糖-6-磷酸-异构酶抗原 抗角蛋白抗体 类风湿因子 

分 类 号：R593.22[医药卫生—内科学]