2种方法检测抗角质蛋白抗体对类风湿性关节炎诊断价值比较  

Comparison of the diagnostic values between two testing methods for anti-keratin antibody in rheumatoid arthritis

作　　者：汤仁仙[1] 秦苏萍[1] 李向阳[1] 杜文平[1] 郑葵阳[1] 

机构地区：[1]徐州医学院病原生物与免疫学教研室,江苏徐州221002

出　　处：《徐州医学院学报》2010年第12期851-853,共3页Acta Academiae Medicinae Xuzhou

基　　金：徐州市科技局课题(XM08C061);徐州医学院课题(08KJ14)

摘　　要：目的比较免疫金银染色法和免疫荧光法检测抗角质蛋白抗体(anti-keratin antibody,AKA)对类风湿性关节炎(rheumatoid arthritis,RA)的诊断价值。方法收集临床上确诊为RA患者血清样本50份,同时收集系统性红斑狼疮(systemic lupus erythematosus,SLE)患者、强直性脊柱炎患者、健康者血清样本各20份作为对照,采用免疫金银染色法和间接免疫荧光法检测AKA,比较分析对RA诊断的敏感性、特异性、正确率、阳性预测值、阴性预测值等指标。结果免疫金银法和免疫荧光法检测AKA阳性率:RA组分别为72%和52%,SLE组分别为0和0,强直性脊柱炎组分别为0和10,健康组分别为0和0。2种方法检测AKA对RA诊断的特异性均很高,无统计学差异。而免疫金银染色法检测AKA对RA诊断的敏感性、正确率及Youden指数均较免疫荧光法高,且差异有统计学意义(P<0.05)。结论免疫金银法检测AKA诊断RA具有高度的敏感性和特异性,临床检测采用免疫金银法检测AKA对RA的辅助诊断更有价值。Objective To compared the value of immunogold-silver staining and immumofluorescence methods for anti-keratin antibody（AKA） in the diagnosis of rheumatoid arthritis（RA）.Methods 50 serum samples from clinically diagnosed RA patients were collected,and control serum samples（n=20 each） were obtained from patients with systemic lupus erythematosus（SLE）,ankylosing spondylitis（AS） and healthy volunteers.All the sera were tested for AKA by immunogold-silver staining and indirect immumofluorescence assay.All the parameters were compared,including sensitivity,specificity,accuracy,positive predictive value,negative predictive value and Youden index.Result The AKA positive rates tested by immunogold-silver staining and immumofluorescence assay were 72% and 52% in RA cases,0 and 0 in RA group,0 and 10% in AS group,0 and 0 in healthy controls.The specificity,accuracy and Youden index of immunogold-silver staining were higher than those of immumofluorescence assay,and the differences were significant（P0.05）.Conclusion The detection of anti-keratin antibody by immunogold-silver staining is highly sensitive and more specific to rheumatoid arthritis,and immunogold-silver staining has more value in detection of AKA for the auxiliary diagnosis of rheumatoid arthritis.

关 键 词：免疫金银染色法 免疫荧光法 抗角质蛋白抗体 类风湿性关节炎 

分 类 号：R593.22[医药卫生—内科学] R446.61[医药卫生—临床医学]