抗环瓜氨酸肽抗体对类风湿性关节炎早期诊断的应用研究  

Application research of anti-cyclic citrullinated peptide antibody in the early diagnosis of rheumatoid arthritis

作　　者：王玉俊[1] 陈洁[1] 万年红[1] 顾军[1] 顾国宝[1] 

机构地区：[1]上海市闸北区中心医院检验科,上海200070

出　　处：《检验医学》2011年第7期440-443,共4页Laboratory Medicine

基　　金：上海市闸北区科委;闸北区卫生局医学科研资助项目(2006一般02)

摘　　要：目的探讨抗环瓜氨酸肽(CCP)抗体对类风湿性关节炎(RA)早期诊断的临床意义。方法应用酶联免疫吸附试验(ELISA)对126例病程<2年的RA患者、135例非RA患者、112名健康体检者进行抗CCP抗体的定量检测,并与类风湿因子(RF)相比较。结果抗CCP抗体在RA组的阳性率为63.5%,明显高于非RA患者组(2.2%)和健康对照组(0.0%),抗CCP抗体的特异性(97.8%)显著高于RF(83.7%),假阳性率(2.2%)显著低于RF(16.3%)(P均<0.001);抗CCP抗体阳性RA患者的红细胞沉降率(ESR)和C反应蛋白(CRP)均显著高于抗CCP抗体阴性的RA患者。对抗CCP抗体阳性而RF阴性的RA患者追踪观察表明,半年后其中42.9%的患者RF转为阳性。结论抗CCP抗体对早期RA诊断有很高的特异性,具有反映RA病情是否活动和帮助判断预后的应用价值;由于血清抗CCP抗体可以较RF先出现,具有早期诊断价值。Objective To investigate the clinical significance of anti-cyclic citrullinated peptide（CCP） antibody in the early diagnosis of rheumatoid arthritis（RA）.Methods Anti-CCP antibody expression levels were detected by enzyme-linked immunosorbent assay（ELISA） and compared with the rheumatoid factor（RF） expression in 126 cases of RA patients with the disease course 2 years,135 cases of non-RA patients and 112 cases of healthy subjects.Results The positive rate of anti-CCP antibody in RA group was 63.5%,and was significantly higher than those in the non-RA group（2.2%） and the healthy control group（0.0%）.The specificity of anti-CCP antibody（97.8%） was higher than that of RF（83.7%）,while the false positive rate（2.2%） was significantly lower than that of RF（16.3%,P0.001）.Erythrocyte sedimentation rate（ESR） and C reactive protein（CRP） level in the anti-CCP antibody positive patients were significantly higher than those in the anti-CCP antibody negative RA patients.The follow-up results to the anti-CCP antibody positive and RF negative patients demonstrated that RF turned to be positive in 42.9% patients after a half year.Conclusions Anti-CCP antibody is highly specific in the early diagnosis of RA,and can reflect the disease progression and help the prognosis prediction.Because the anti-CCP antibody appears earlier than RF,anti-CCP antibody has an early diagnosis value.

关 键 词：抗环瓜氨酸肽抗体 类风湿性关节炎 类风湿因子 早期诊断 评价 

分 类 号：R446.62[医药卫生—诊断学]