抗CCP抗体和AKA在类风湿关节炎诊断的应用价值  

Anti-CCP and Anti-AKA Application Value in the Diagnosis of Rheumatoid Arthritis

作　　者：姚春红[1] 邓建平[1] YAO Chun- hong DENG Jian- ping(Clinical Laboratory of Huangshi Aikang Hospital, Huangshi 435000, Chin)

机构地区：[1]黄石市爱康医院,湖北黄石435000

出　　处：《标记免疫分析与临床》2016年第12期1454-1456,1482,共4页Labeled Immunoassays and Clinical Medicine

摘　　要：目的比较抗环瓜氨酸肽抗体(抗CCP抗体)和抗角蛋白抗体(AKA)在类风湿关节炎诊断中作用,探讨RA的早期诊断方法。方法对已确诊的85例RA患者、74例非RA的自身免疫病患者同时测定抗CCP抗体(ELISA法)、AKA(间接免疫荧光检测)。结果抗CCP抗体对诊断RA的灵敏度和特异性分别为75.3%和93.2%;AKA对RA诊断的灵敏度和特异性分别为89.4%和85.14%。抗CCP抗体的灵敏度与AKA灵敏度差异无统计学意义(P>0.05),特异性差异有统计学意义(P<0.05);抗CCP抗体或AKA与二者联合检测的灵敏度差异有统计学意义(P<0.05),特异性差异有统计学意义(P<0.05)。阳性预测值抗CCP抗体较高,阴性预测值以二者联合检测较好,Youden index二者联合检测比单独检测抗CCP抗体或AKA高。抗CCP抗体和AKA在检测RA组中抗CCP抗体和AKA同时阳性检出58例;抗CCP抗体或AKA阳性共检出85例。抗CCP抗体或AKA阳性率(96.5%)比二者同时阳性率(68.2%)大大提高。结论抗CCP抗体、AKA对RA具有较好的灵敏度和高度的特异性,联合检测抗CCP抗体和AKA可作为早期RA患者及RF阴性RA患者的早期诊断指标。Objective To compare the diagnostic value of anti-CCP and anti-AKA in rheumatoid arthritis and to explore the early diagnosis of rheumatoid arthritis （RA）. Methods The anti- CCP （ELISA） and anti- AKA （ indirect immunofluorescence assay） were used in 85 patients with RA and 74 patients with non- RA. Results The sensitivity and specificity of anti-CCP for the diagnosis of RA were 75.3% and 93.2%. The sensitivity and specificity of anti-AKA were 89.4% and 85.1%. There was no significant difference on the sensitivity of between anti-AKA and anti-CCP （P 〉 0. 05 ）. On the specificity of anti-AKA, the difference was significant （ P 〈 0.05 ）. The difference on sensitivity of anti-CCP and antAKA combined detection was statistically significant （P 〈 0.05 ）. The specificity of anti-CCP and anti-AKA combined was statistically significant （ P 〈 0.05 ）. Anti- CCP antibodies were higher for positive predictive value, combined detection of both offered high negative predictive value. Youden index on combined detection of anti-CCP or anti-AKA was higher than tested. Anti-CCP and anti-AKA were detected in 58 cases, anti-CCP or AKA positive in 85 cases. The positive rate of anti-CCP or anti-AKA（96.5% ） was significantly higher than that（68.2% ）. Conclusion Anti-CCP and anti-AKA have higer sensitivity and specificity for diagnosis of RA. Combined detection of anti-CCP and anti-AKA can be used as good diagnostic indicators for early RA patients and RF negative RA patients.

关 键 词：抗环瓜氨酸肽抗体 抗角蛋白抗体 类风湿关节炎 

分 类 号：R593.22[医药卫生—内科学]