抗CCP抗体和RF对类风湿关节炎诊断价值的评价  

Evaluate the value of anti-CCP antibody and RF in diagnosis of rheumatoid arthritis

作　　者：朱继文[1] 章小军[1] 朱华[1] 戴宝平 王涛[1] 

机构地区：[1]泰兴市第二人民医院检验中心,江苏泰兴225400

出　　处：《国际检验医学杂志》2015年第18期2681-2682,2685,共3页International Journal of Laboratory Medicine

摘　　要：目的评价单项检测抗环瓜氨酸肽抗体(抗CCP抗体)或类风湿因子(RF)及两者联合检测诊断类风湿关节炎(RA)的作用。方法选取56例RA患者纳入RA组,34例非RA患者纳入非RA组,采用电化学发光免疫分析(ECLIA)测定RF与抗CCP抗体水平,比较两组RA及抗CCP抗体水平,并评价RA与抗CCP抗体单项及联合检测的诊断效能。结果 RA组患者抗CCP抗体和RF水平均高于非RA组,差异有统计学意义(均P<0.05)。在RA诊断中,抗CCP抗体和RF的受试者工作特征(ROC)曲线下面积分别为0.925和0.822,抗CCP抗体的灵敏度和特异度均高于RF。与抗CCP抗体单项检测相比,抗CCP抗体/RF不能明显提高诊断灵敏度,而特异度明显下降;抗CCP抗体+RF特异度无明显变化,但灵敏度明显下降。结论 RA诊断中,抗CCP抗体检测优于RF,两者联合检测不能明显提高灵敏度和特异度,建议采用单项检测抗CCP抗体诊断RA。Objective To evaluate the effectiveness of using anti‐cyclic citrullinated peptide （anti‐CCP） antibody or rheumatoid factor（RF） as the single laboratory parameter for rheumatoid arthritis（RA） diagnosis ,versus to using the two parameters in com‐bination .Methods A total of 56 cases of patients with RA were enrolled into RA group ,other 34 cases of patients with out RA were enrolled into non‐RA group .Levels of anti‐CCP antibody and RF were detected by using electro‐chemiluminescence immunoas‐say（ECLIA）and compared between the two groups .And the diagnostic efficacy of single and combined detection of anti‐CCP anti‐body and RF were evaluated .Results The levels of anti‐CCP antibody and RF in the RA group were higher than those in the non‐RA group ,had statistically significant differences（P〈0 .05） .In diagnosis of RA ,the areas under receiver operating characteristic （ROC）curve of anti‐CCP antibody and RF were 0 .925 and 0 .822 respectively .The sensitivity and specificity of anti‐CCP antibody were both higher than those of RF .Compared with single detection of anti‐CCP antibody ,there was no significant increase of sensi‐tivity in using anti‐CCP antibody/RF ,whereas the specificity dropped significantly .Combined detection of anti‐CCP antibody and RF ,compared with single detection of anti‐CCP antibody ,had significantly lower sensitivity ,but no significant changes were found in specificity .Conclusion Single detection of anti‐CCP antibody is more effective than RF for diagnosing RA ,while combined detec‐tion of anti‐CCP antibody and RF could not significantly improve the specificity and sensitivity .It is suggested to only use anti‐CCP antibody for diagnosis of RA .

关 键 词：类风湿关节炎 抗环瓜氨酸肽抗体 类风湿因子 

分 类 号：R593.22[医药卫生—内科学]