抗环瓜氨酸多肽抗体在类风湿关节炎诊断中的价值  

The specificity of anti-cyclic citrullinated peptide antibodies in the diagnosis of rheumatoid arthritis _ v ;e1 from a large cohort study in the Chine

作　　者：李婷[1] 包军[1] 殷健[1] 徐沪济[1] 

机构地区：[1]长征医院风湿免疫科,上海200003

出　　处：《中华内科杂志》2011年第2期99-101,共3页Chinese Journal of Internal Medicine

摘　　要：目的了解抗环瓜氨酸多肽（CCP）抗体在中国人群中诊断类风湿关节炎的敏感度、特异度及其对类风湿关节炎发病的预测价值。方法收集2007年11月至2008年3月在上海长征医院进行健康体检的健康人群1018例，风湿科门诊及住院确诊类风湿关节炎患者212例，其他结缔组织病患者435例，应用酶联免疫吸附法检测其血清抗CCP抗体滴度，对健康人群及类风湿关节炎患者同时检测IgM型类风湿因子（IgM—RF）。比较抗CCP抗体阳性率及滴度差异，并统计健康人群和类风湿关节炎患者中IgM—RF的阳性率，计算IgM—RF诊断类风湿关节炎的特异度。结果（1）类风湿关节炎患者血清抗CCP抗体阳性率为48．1％（102例），明显高于健康人群（2．6％，26例）和其他结缔组织病患者（3．7％，16例），其诊断类风湿关节炎的特异度高达97．4％。（2）类风湿关节炎患者抗CCP抗体滴度为429．7U，明显高于健康人群（29．3u）和其他结缔组织病患者（36．5u）。（3）lgM—RF在类风湿关节炎患者中的阳性率为94．3％，而在健康人群中的阳性率为21．5％。抗CCP抗体的假阳性率（2％）显著低于IgM—RF（21．5％，P〈0．01）。结论抗CCP抗体在类风湿关节炎诊断中具有高度的特异度，且类风湿关节炎患者血清中抗CCP抗体滴度明显高于健康人群及其他结缔组织病患者。抗CCP抗体阳性对类风湿关节炎的诊断更具有价值。Objective To determine the sensitivity and specificity of anti-cyclic citrullinated peptide antibodies （anti-CCP antibodies） in the diagnosis of rheumatoid arthritis. Method A total of 1018 healthy donors, 212 patients with rheumatoid arthritis, 435 patients with other connective tissue disease were recruited to this study. Anti-CCP antibodies and IgM-rheumatoid factor （RF） were determined by ELISA according to manufacturer instructions, with a cut-off of 20U. Result The frequency of positive anti-CCP antibodies in patients with rheumatoid arthritis is 48. 1% （n = 102）, higher than healthy donors （2.6% , n = 26） and patients with other connective tissue diseases （3.7% , n = 16）. The specificity of anti-CCP antibodies is 97.4%. The titer of anti-CCP antibodies in patients with rheumatoid arthritis （ 429. 7 U ） is much higher than that in healthy donors （29. 3 U） and patients with other connective tissue diseases （36.5 U）. The frequency of positive IgM-RF in patients with rheumatoid arthritis is 94. 3% whilst only 21.5% in healthy donors. The false positivity rate of IgM-RF is higher than anti-CCP antibody. Conclusion Anti-CCP antibodies is a highly specific autoantibodv in the diaanosis of rheumatoid arthritis.

关 键 词：关节炎 类风湿 抗环瓜氨酸抗体 敏感性与特异性 

分 类 号：R593.22[医药卫生—内科学]