类风湿关节炎患者血清自身抗体对其诊断价值分析  

Diagnostic value of anti-cyclic citrullinated peptide antibody,antikeratin antibody and rheumatoid factor in patients with rheumatoid arthritis

作　　者：尹海琴[1] 李宝全[1] 巩路[1] 

机构地区：[1]天津医科大学总医院感染免疫科,天津300052

出　　处：《天津医科大学学报》2011年第1期57-60,共4页Journal of Tianjin Medical University

摘　　要：目的:分析抗环瓜氨酸肽抗体(抗CCP抗体)、抗角质蛋白抗体(AKA)及各型类风湿因子(RF)联合检测对类风湿关节炎(RA)诊断与病情活动等方面的作用。方法:选取80例RA患者和75例非RA患者,进行相关实验室指标测定,并对结果进行统计学分析。结果:RF-IgG、RF-IgA、RF-lgM、AKA及抗CCP抗体对RA的敏感性为:RF-IgM>抗CCP抗体>RF-IgG>RF-IgA>AKA;特异性为:AKA>抗CCP抗体>RF-IgG>RF-IgA>RF-IgM;联合检测2种、3种、5种抗体对RA的敏感性和特异性分别是:RF-IgA+RF-lgM为51.3%/81.3%,RF-IgG+RF-IgA+RF-lgM为43.8%/89.3%,RF-IgA+RF-lgM+抗CCP抗体为45%/98.7%,RF-IgA+RF-lgM+AKA为22.5%/98.7%,RF-IgG+RF-IgA+RF-lgM+抗CCP抗体+AKA为18.8%/100%;抗CCP抗体阳性和阴性患者在RF滴度值、ESR和晨僵方面差异存在统计学意义(P<0.05)。结论:抗CCP抗体在诊断RA中的价值优于AKA和RF;抗CCP抗体在一定程度上可能有助于早期诊断和活动性的监测;RF与抗CCP抗体、AKA联合检测可进一步提高对RA诊断的特异性。Objective： To analyze the value of anti-CCP,anti-AKA and rheumatoid factor antibodies（RF-IgA,RF-IgG,RF-IgM） in diagnosis and prognosis in patients with rheumatoid arthritis（RA）.Methods：80 RA patients and 75 patients with other rheumatic diseases were investigated,the relationship between them was analysed with SPSS17.0 software.Results：The sensitivity of RF-IgG,RF-IgA,RF-IgM,anti-AKA and anti-CCP was RF-IgManti-CCPRF-IgG RF-IgAAKA;and the specificity was AKAanti-CCPRF-IgGRF-IgARF-IgM;The sensitivity and specificity of combined detection of RF-IgA and RF-IgM were 51.3% and 81.3%,that of combined detection of RF-IgG,RF-IgA and RF-IgM were 43.8% and 89.3%,that of combined detection of RF-IgA,RF-lgM and anti-CCP were 45% and 98.7%,that of combined detection of RF-IgA,RF-lgM and AKA were 22.5% and 98.7%,that of combined detection of RF-IgG,RF-IgA,RF-lgM,anti-CCP and AKA were 18.8% and 100%;There were statistically significant（P0.05） in RF titer values,ESR and morning stiffness in anti-CCP antibody-positive and-negative patients.Conclusion：Anti-CCP antibodies in the diagnosis of RA is more valuable than the AKA and RF;Anti-CCP antibodies,in a certain extent,may contribute to judgments and disease activity monitoring;the specificity of diagnosis of RA can be enhanced by joint detection of RF,AKA and anti-CCP.

关 键 词：关节炎 类风湿 抗环瓜氨酸肽抗体 抗角蛋白抗体 类风湿因子 

分 类 号：R593.22[医药卫生—内科学]