葡萄糖-6-磷酸异构酶与抗环瓜氨酸肽抗体对类风湿关节炎诊断意义的比较研究  

Comparative Study on Diagnostic Values of Glucose-6-phosphate Isomerase and Anti-cyclic Citrullinated Peptide Antibodies for Patients with Rheumatoid Arthritis

作　　者：田玉梅[1,2] 张浩[2] 刘立亚[1] 

机构地区：[1]湖南省怀化医学高等专科学校,湖南怀化418000 [2]中南大学湘雅三医院风湿免疫科

出　　处：《实用预防医学》2011年第4期609-612,共4页Practical Preventive Medicine

摘　　要：目的比较葡萄糖-6-磷酸异构酶(glucose-6-phosphate isome-rase,GPI)和抗环瓜氨酸肽(anti-cycliccitrullinated peptide,anti-CCP)抗体对类风湿关节炎(rheumatoid arthritis,RA)的诊断意义。方法收集未经治疗的128例RA患者(RA组)、117例其他风湿病人(非RA组)、74例健康人(正常对照组)血清,采用酶联免疫吸附法(ELISA)检测GPI、抗CCP抗体,采用速率散射比浊法检测RF、C反应蛋白(CRP)、补体(C3、C4)、免疫球蛋白(IgA、IgG、IgM),采用魏氏法测红细胞沉降率(血沉,ESR)。结果⑴GPI、抗CCP抗体诊断RA的特异性(分别为91.09%、94.14%)、敏感性(分别为75.0%、75.8%)差异均无统计学意义(P>0.05),但二者特异性与RF(78.53%)比差异有统计学意义(P<0.01)。⑵GPI、抗CCP抗体分别与RF联合检测,两个指标均为阳性诊断RA的特异性(分别为94.24%、95.81%)差异无统计学意义(P>0.05),与单独检测RF比差异有统计学意义(P<0.01);两个指标任一阳性诊断RA的敏感性(分别为85.16%、85.94%)差异无统计学意义(P>0.05),与单独检测GPI或抗CCP抗体比差异有统计学意义(P<0.05)。⑶GPI阳性的RA患者关节炎部位数、CRP、ESR水平明显高于GPI阴性RA患者,且差异有统计学意义(P<0.05)。结论 GPI诊断RA具有与抗CCP抗体相似的特异性和敏感性。与RF联合检测可提高诊断RA的特异性和敏感性。此外,GPI还可作为RA活动性指标。Objective To compare the diagnostic values of glucose-6-phosphate isomerase（GPI） and anti-cyclic citrullinated peptide（anti-CCP） antibodies for the patients with rheumatoid arthritis（RA）. Methods Serum GPI and anti-CCP antibody levels were detected by enzyme-linked immunosorbent assays（ELISAs） in 128 patients with rheumatoid arthritis（RA group）,117 other rheumatic diseases（non-RA group）,and 74 healthy subjects（normal control group）.Rheumatoid factor（RF）,C-reactive protein（CRP）,complement 3（C3）,complement 4（C4）,immunoglobulin A（IgA）,immunoglobulin G（IgG）,and immuno-globulin M（IgM） were examined with rate scatter nephelometry.Erythrocyte sedimentation rate（ESR） was determined by Westergren method. Results Comparing with anti-CCP（94.14%,75.8%）,the specificity and the sensitivity of GPI（91.09%,75.0%） had no statistical significance（P0.05）.Comparing with RF（78.53%）,the specificity of GPI increased significantly（P0.01）.Comparing with anti-CCP and RF（95.81%）,the specificity of GPI and RF（94.24%） had no statistical significance（P0.05） when both indexes were positive simultaneously.When either index was positive,the same as the sensitivity of the two groups（85.16% and 85.94%,respectively）.The GPI positive group had higher levels with arthritis parts,ESR,CRP than the GPI negative group in the patients of RA,and the difference was statistically significant（P0.05）. Conclusions The specificity and sensitivity of GPI were as high as those of anti-CCP in diagnosis of RA.Both sensitivity and specificity of detection were improved when the combined detection of GPI and RF or anti-CCP and RF for the patients with RA.In addition,GPI was one of the rheumatoid activity markers.

关 键 词：葡萄糖-6-磷酸异构酶 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]