抗瓜氨酸化蛋白/肽抗体对类风湿关节炎的诊断价值  

Comparasion of Diagnostic Values of Anti-citrullinated Protein/Peptide Autoantibodies in Rheumatoid Arthritis

作　　者：吴庆军[1] 曾小峰[1] 史艳萍[1] 白依娜[1] 甘晓丹[1] 唐福林[1] 

机构地区：[1]中国医学科学院北京协和医学院北京协和医院风湿免疫科,北京100730

出　　处：《中华临床免疫和变态反应杂志》2008年第4期261-265,共5页Chinese Journal of Allergy & Clinical Immunology

摘　　要：目的探讨4种抗瓜氨酸化蛋白/肽抗体(anti-citrullinated protein/peptide autoantibodies,ACPAs)-抗核周因子(anti-perinuclear fator,APF)、抗角蛋白抗体(anti-keratin antibody,AKA)、抗角蛋白微丝聚集蛋白抗体(anti-profillagrin/fillagrin antibody,AFA)、第二代抗环瓜氨酸肽抗体(second generation of anti-cylic citrulline peptideantibody,CCPⅡ)对类风湿关节炎(rheumatoid arthritis,RA)的诊断意义及其结果的一致性。方法对129例RA、153例其他风湿性疾病患者和94名健康对照者的血清进行类风湿因子(rheumatoid factor,RF)和ACPAs检测。RF采用乳胶间接凝集法检测,APF和AKA采用间接免疫荧光法检测,AFA、抗CCP(Ⅱ)抗体采用酶联免疫吸附法检测。结果APF、AKA、AFA和抗CCP(Ⅱ)抗体对RA的诊断特异性分别为90.3%、94.7%、93.5%和94.7%,敏感性分别为58.1%、40.3%、62.0%和67.4%;而RF的诊断特异性和敏感性为77.7%和46.5%。APF与AFA、APF与抗CCP(Ⅱ)和AFA与抗CCP(Ⅱ)抗体间检测结果一致性较好,Kappa值分别是0.596、0.572和0.576。结论ACPAs是RA的诊断特异性抗体,其中抗CCP(Ⅱ)抗体的敏感性和特异性最高,且与APF和AFA抗体间结果具有明显的一致性。To analyze the diagnostic value and relationship of anti-citrullinated protein/peptide autoantibodies （ACPAs） -anti-perinuclear fator （APF）, anti-keratin antibody （AKA）, anti-profillagrin/fillagrin antibody （AFA）, and second generation of anti-cylic citrulline peptide antibody （anti-CCP Ⅱ ） in rheumatoid arthritis （RA）. Methods Three hundred and seventy-six serum samples, including 129 RA cases, 153 non-RA rheumatic disease cases, and 94 healthy subjects were enrolled. Rheumatoid factor （RF） was detected by latex agglutination test. APF and AKA were detected by indirect immunofluores- cence test. AFA and anti-CCP （Ⅱ） antibody were measured by enzyme linked immunosorbent assay test. Results The sensitivities of RF, APF, AKA, AFA, and anti-CCP （Ⅱ） for RA were 46.5%, 58.1%, 40.3%, 62.0%, and 67.4% respectively, their specificities were 77.7%, 90.3%, 94.7%, 93.5%, and 94.7%respectively. The Kappa values between APF and AFA, APF and anti-CCP （Ⅱ） antibody, AFA and anti-CCP （II） antibody were 0.596, 0.572, and 0.576 respectively. Conclusion Among ACPAs, anti-CCP （Ⅱ） antibody was the most sensitive and specific item for RA and had good con-sistency with APF and AFA.

关 键 词：抗瓜氨酸化蛋白/肽抗体 第二代抗环瓜氨酸肽抗体 类风湿关节炎 

分 类 号：R593.22[医药卫生—内科学] R44[医药卫生—临床医学]