ECLIA、CMIA、ELISA3种方法测定血清抗CCP抗体在RA诊断中的应用  

Application of three kinds of detection method ECLIA,CMIA,ELISA for detecting serum anti-CCP antibody in diagnosis of RA

作　　者：康霞[1] 李欣[1] 杨春莉[1] 冯平锋[1] 潘洁[1] 袁帅[1] 裘宇容[1] 

机构地区：[1]南方医科大学南方医院临床检验中心,广东广州510515

出　　处：《重庆医学》2014年第11期1290-1292,1295,共4页Chongqing medicine

基　　金：广东省教育部产学研结合项目(2010B090400542;2012B091100461);广州市科技计划资助项目(12A62121523)

摘　　要：目的评价电化学发光法(ECLIA)、化学发光法(CMIA)及酶联免疫吸附测定法(ELISA)3种方法测定血清抗环瓜氨酸肽(CCP)抗体的差异及在类风湿关节炎(RA)诊断中的作用。方法采用ECLIA、CMIA及ELISA测定45例临床确诊的RA患者、34例非RA患者及24例其他患者(包括HBsAg阳性9例、anti-HCV阳性8例、EB-IgA阳性7例)血清中抗CCP抗体水平。结果 3种方法测定所有标本抗CCP抗体阳性率差异无统计学意义(P>0.05),但ELISA与ECLIA及CMIA间的一致性均较差(Kappa<0.75),ECLIA与CMIA间一致性良好(Kappa>0.75),ECLIA灵敏度优于CMIA及ELISA,CMIA特异性优于ECLIA及ELISA。HBsAg、anti-HCV、EB-IgA阳性均可造成ELISA结果假阳性,累计阳性率达33.33%。结论在临床标本抗CCP抗体检测中,ECLIA灵敏度最高,CMIA特异性最好,ECLIA、CMIA优于ELISA,具有重要临床应用价值。Objective To evaluate the differences of electrochemiluminescence immunoassay（ECLIA）,chemiluminesence immu- noassay（CMIA） and enzyme-linked immunosorbent assay（ELISA） for detecting serum anti-CCP antibody and their role in diagno- sing rheumatoid arthritis（RA）. Methods ECLIA,CMIA and ELISA were adopted to detect serum anti-CCP antibody in 45 patients with confirmed RA,34 cases of non-RA and other 24 patients,including 9 Cases of positive HBsAg,8 cases of positive anti-HCV and 7 cases of positive EB^IgA, respectively. Results The positive rate of anti-CCP antiboy in all samples detected by ECLIA, CMIA and ELISA had no statistically significant difference（P^0.05）. But the coincidences between ELISA with ECLIA and be- tween ELISA with CMIA were poor（KappaS0.75）, while which between ECLIA with CMIA was well（Kappa〉0.75）. ECLIA showed better sensitivity than CMIA and ELISA,while the specificity of CMIA was superior to that of ECLIA and ELISA. HB- sAg,anti-HCV and positive EB-IgA could cause the false-positive of anti-CCP antibody detected with ELISA, the accumulated posi- tive rate reached to 33.33~. Conclusion In the anti-CCP antibody detection of clinical samples,ECLIA has the highest sensitivity and CMIA has the best speeificity,ECLIA and CMIA are superior to ELISA with important application value in clinic.

关 键 词：电化学发光法 化学发光法 酶联免疫吸附测定 抗环瓜氨酸肽抗体 关节炎 类风湿 

分 类 号：R446.6[医药卫生—诊断学]