各种检验指标在类风湿性关节炎诊断中的应用  

Applications of Serologic Indicators in the Diagnosis of Rheumatoid Arthritis

作　　者：由艳秋[1] 

机构地区：[1]哈尔滨医科大学附属第二医院,黑龙江哈尔滨150086

出　　处：《黑龙江医学》2011年第8期566-569,共4页Heilongjiang Medical Journal

摘　　要：目的评价CCP抗体及RF在RA诊断中的价值以及CRP、ANA做为辅助指标的临床意义。方法收集89例RA患者,55例SLE患者与31例其它自身免疫性疾病患者血浆,采用间接免疫荧光法检测ANA,ELISA方法测定抗CCP抗体,免疫散射比浊法测定RF及CRP,分别比较抗CCP抗体及RF的敏感性和特异性。结果 RA组抗CCP抗体敏感性为79.79%、RF敏感性为82.02%,抗CCP抗体与RF敏感性比较,差异无统计学意义(P>0.05)。抗CCP抗体的特异性为93.02%、RF特异性为91.86%,抗CCP抗体与RF特异性比较,差异无统计学意义(P>0.05)。SLE组RF敏感性为5.45%、抗CCP抗体敏感性为3.64%。抗CCP抗体的特异性为44.17%,RF特异性为35.83%。其他自身免疫性疾病组抗CCP抗体、RF的敏感性分别为12.19%、12.19%,特异性分别为54.86%、47.22%。RA组抗CCP抗体、RF的敏感性和特异性与SLE组和其他自身免疫性疾病组比较,差异具有显著性(P<0.05)。结论抗CCP抗体和RF可用于RA诊断的敏感性和特异性无明显区别。Objective To investigate the value of anti-cyclic citrullinated peptide（CCP） antibody and rheumatoid factor（RF）,the clinical significance of antinuclear antibody（ANA） and C reactive protein（CRP） as assist indicator in the diagnosis of rheumatoid arthritis（RA）.Methods Collect 89 rheumatoid arthritis patients and 55 systemic lupus erythematosus patients and 31 other autoimmune disease patients as control,ANA was detected by indirect immunofluorescence,anti-CCP was detected by ELISA,RF and CRP were detected by BNⅡnephelometer,analyze their specificity and sensitivity,respectively.Results The sensitivity of anti-CCP and RF in RA group was 79.79%,82.02%,respectively.With respect to the sensitivity of anti-CCP and that of RF,there was no significant difference between them（P0.05）.The specificity of anti-CCP and RF in RA group was 93.02%,91.86%,respectively.With respect to the specificity of anti-CCP and that of RF,there was no significant difference between them（P0.05）.The sensitivity of RF and anti-CCP in SLE group was 5.45%,3.64%,respectively,The specificity of anti-CCP and RF in SLE group was 44.17%,35.83%,respectively.The sensitivity of anti-CCP and RF in other autoimmune disease group was 12.19%,12.19%,respectively,and the specificity of them was 54.86%,47.22%,respectively;The sensitivity and the specificity of anti-CCP and RF in RA group were significantly higher than those in SLE group and in other autoimmune disease group（P0.05）.Conclusion Anti-cyclic citrullinated peptide antibody and Rheumatoid factor have higher value for RA diagnosis,and there was no significant difference between them.

关 键 词：类风湿性关节炎 抗环瓜氨酸抗体 类风湿因子 抗核抗体 C反应蛋白 

分 类 号：R593.22[医药卫生—内科学]