抗环瓜氨酸肽抗体联合类风湿因子对老年类风湿关节炎的诊断价值分析  

Diagnostic value analysis of anti-CCP antibodies combined RF on elderly patients with rheumatoid arthritis

作　　者：陶蕾[1] 薛建峰[2] 翟乾勋[1] 薛夫营[2] 翟荣慧[2] 

机构地区：[1]泰山医学院附属医院风湿免疫科,山东泰安271000 [2]泰安市中心医院老年病科,山东泰安271000

出　　处：《中国生化药物杂志》2015年第3期103-105,共3页Chinese Journal of Biochemical Pharmaceutics

摘　　要：目的：探讨抗环瓜氨酸肽（ cyclic citrullinated peptides，CCP）抗体联合类风湿因子（ rheumatoid factors，RF）对老年类风湿性关节炎的诊断价值。方法选取2012年1月～2014年12月间泰山医学院附属医院老年类风湿性关节炎患者29例（老年RA组，年龄≥60岁）、老年健康对照组47例（老年NRA组，年龄≥60岁）及非老年类风湿性关节炎患者48例（非老年RA组，年龄＜60岁）。对3组抗CCP抗体、类风湿因子进行检测，分析抗CCP抗体联合RF在老年类风湿性关节炎诊断中的意义。结果抗CCP抗体＋RF诊断阳性率显著性高于抗CCP抗体，差异有统计学意义（χ2＝7．632，P＝0．006）；抗CCP抗体＋RF诊断阳性率高于RF，差异无统计学意义（χ2＝3．107，P＝0．078）。老年RA组抗CCP抗体、RF、抗CCP抗体＋RF诊断阳性率与非老年RA组比较，差异均无统计学意义。抗CCP抗体＋RF诊断的敏感度、阴性预测值明显高于抗CCP抗体和RF单一使用。抗CCP抗体＋RF诊断老年RA的ROC曲线下面积为0．786，远高于抗CCP抗体的0．699和RF的0．663，检验更加可靠。结论抗CCP抗体、RF均可对老年发病的类风湿性关节炎进行诊断，抗CCP抗体联合RF诊断更具临床意义。Objective To investigate the diagnostic value of anti-cyclic citrullinated peptides （ CCP ） antibodies combined rheumatoid factors （RF） on elderly patients with rheumatoid arthritis.Methods From January 2012 to December 2014, 29 cases of elder patients in our hospital with rheumatoid arthritis （elder RA group, age 〉60 year）, 47 cases of elderly health control group （elder RA group, age≥60）, and 48 cases of elder patients without rheumatoid arthritis （non-elder RA group, age〈60 year） were selected.The anti-CCP antibodies and rheumatoid factor （RF） levels of three groups were detected, and the significance of anti-CCP antibody combined RF on the diagnosis of elderly rheumatoid arthritis was analyzed.Results Diagnostic positive rate of anti-CCP antibodies ＋RF was significantly higher than that of anti-CCP antibodies, and the difference was significant （χ2 =7.632, P =0.006）.Diagnostic positive rate of anti-CCP antibodies ＋RF was higher than that of RF, but the difference was not statistically significant （χ2 =3.107, P=0.078）.The diagnostic positive rate of anti-CCP antibodies, RF, and anti-CCP antibodies ＋RF for diagnosis of elderly rheumatoid arthritis had no statistically difference with that of non-elderly RA group.The sensitivity and negative predictive value of anti-CCP antibodies ＋RF was higher than that of only anti-CCP antibodies and RF.The area under the ROC curve of detecting anti-CCP ＋RF was 0.786, which was higher than that of anti-CCP antibodies （0.699） and RF （0.663）, indicated that the reliability of anti-CCP antibodies ＋RF was higher than that of anti-CCP antibodies and RF.Conclusion The anti-CCP antibodies and RF can diagnose elderly rheumatoid arthritis, and anti-CCP antibodies combined RF has more clinical significance.

关 键 词：类风湿性关节炎 老年 抗环瓜氨酸肽抗体 类风湿因子 联合诊断 

分 类 号：R44[医药卫生—诊断学]