ICTP、MMP-3、抗CCP抗体和RF检测对早期RA患者的诊断应用  

Diagnosis and Application of Combine Detection on Pyridine Cross-linked Comprehensive Peptide of Type Ⅰ Collagen,Matrix Metalloproteinase Enzyme-3 Projects,CCP and RF in Patients with Early Rheumatoid Arthritis

作　　者：董奕裕 张新根 陆建良 于国芳 陆鑫丽 

机构地区：[1]浙江省荣军医院检验科,314000 [2]浙江省荣军医院中西医结合骨伤科,314000 [3]浙江省荣军医院放射科,314000 [4]浙江省荣军医院风湿免疫科,314000

出　　处：《放射免疫学杂志》2013年第3期330-333,共4页Journal of Radioimmanology

基　　金：嘉兴市科技局计划项目(2010AY1053)

摘　　要：目的:探讨Ⅰ型胶原吡啶交联终肽(ICTP)、基质金属酶-3(MMP-3)、抗环瓜氨酸肽抗体(抗CCP抗体)、类风湿因子(RF)检测对于早期类风湿关节炎(RA)患者疾病进程的预测价值。方法:2010年1月～2012年6月对我院风湿免疫科门诊及住院RA患者249例(RA组,其中早期RA112例)、非RA的其他免疫系统疾病患者41例(非RA对照组)及健康对照(正常对照组)60例,采用ELISA定量检测血清ICTP、MMP-3、抗CCP抗体,采用免疫比浊法测定血清RF。结果:①抗CCP抗体、RF在RA各组血清水平均高于非RA及正常对照组(P<0.01),ICTP、MMP-3、RF在非RA组中水平与正常对照组比较(P<0.01),差别有统计学意义。ICTP在早期RA与非RA组差别无统计学意义(P>0.05);MMP-3在中晚期具有较高含量,显著高于其它各组(P<0.01),在早期RA组与长期RA组中水平比较无差异(P>0.05),但与正常对照组比较,均有统计学意义(P<0.01)。②在抗CCP抗体与ICTP、MMP-3、RF间无统计学意义(P>0.05),但可同时作为RA早期诊断指标。③ICTP、MMP-3、抗CCP抗体与RF表明,四种血清标志物联检对早期RA诊断灵敏度为43.8%,特异性99.0%,诊断早期RA的敏感性有所下降,但特异性有所提高。结论:联检四种血清标志物可降低RA的漏诊率。动态联检ICTP、抗CCP抗体、RF、MMP-3能更有效地及时监测RA的疾病进展,对指导临床诊治及干预有积极意义。Objective To explore the end of the cress-linking of type I collagen pyridine final peptide pyridine （ICTP）, matrix metalloenzymes -3 and （MMP-3）, anti-cyclic citrullinated peptide （CCP） antibodies, rheumatoid factor （RF） detection for early rheumatoid arthritis （RA） patients and the predictive value of the disease process. Methods From January 2010 to June 2012, 249 cases of rheumatism in outpatient department and hospitalized patients with RA （RA group, which 121 cases were early RA） and 41 cases of non-RA patients with other immune system diseases （non-RA control group） and 60 cases of healthy subjects （healthy control group）, using quantitative ELISA to measure serum ICTP, MMP-3, anti-CCP antibodies. Besides, serum RF with turbidimetric immunoassay. Results （ 1 ） Anti-CCP, RF serum levels in RA on average showed significantly higher than non-RA and the control group （P 〈0.01 ）. A comparison of ICTP, MMP-3, RF levels in the non-RA group higher than the normal greup（P 〈0.01 ）, presented statistically significant difference in early RA and non-RA group, ICTP indicated no statistical significance （P 〉 0.05） ; MMP-3 has a higher content in the middle and late period, which manifested markedly higher than the other groups （P 〈0.01 ） obvious difference （P 〉 0.05） compared to early RA patients with long-term RA group compared with the normal control group, were different （ P 〈 0.01 ）. （2） Among anti-CCP, ICTP, MMP-3 and the RF showed no statistically significance （P 〉0.05）, but might be used as an indicator in early diagnosis of RA. （3） ICTP, MMP-3, anti-CCP and anti RF four serum standards, combined detection of early RA diagnosis, the sensitivity 43.8% and specificity 99.0% individually, decreased in the sensitivity for diagnosis of early RA, but the specificity increased. Conclusion Combined detection of four serum indicators, can reduce the rate of misdiagnosis of RA. Dynamic joint determination of ICTP, anti-CCP antibodies, RF

关 键 词：基质金属酶-3 I型胶原吡啶交联终肽 抗环瓜氨酸肽抗体 类风湿因子 类风湿关节炎 

分 类 号：R259.932.2[医药卫生—中西医结合]