抗环瓜氨酸肽抗体等风湿四项联合检测对类风湿关节炎的诊断价值  

Clinical Application of Anti-cyclic Citrullinated Peptide Antibody Combined with Other Three Rheumatoid Indicators in the Diagnosis of Rheumatoid Arthritis

作　　者：林荣华[1] 林养[1] 吴春芳[1] 邓丽花[1] 

机构地区：[1]湛江市第四人民医院检验科,广东湛江524008

出　　处：《沈阳医学院学报》2017年第2期94-96,99,共4页Journal of Shenyang Medical College

摘　　要：目的:探讨抗环瓜氨酸肽(CCP)抗体等四项指标联合检测在类风湿关节炎(RA)诊断中的意义。方法:选择RA患者78例(RA组),非RA的自身免疫疾病患者72例(非RA组),体检健康者75例(对照组),采用免疫比浊法检测抗CCP抗体、类风湿因子(RF)和C-反应蛋白(CRP);采用Westergren法检测血沉(ESR),分析其在RA诊断中的价值。结果:RA组和非RA组患者抗CCP抗体、RF、CRP、ESR水平与健康对照组比较,四项指标均显著升高,差异有统计学意义(P<0.05);而RA组与非RA组比较仅抗CCP抗体和RF升高(P<0.05)。四项指标对诊断RA的灵敏度分别为73.1%、71.8%、70.5%、69.2%,特异度分别为91.75%、88.9%、52.8%、50.0%。各指标单独检测时,抗CCP抗体诊断RA的灵敏度及特异度均最高,其次是RF,而CRP和ESR对诊断RA的特异度最低。RA患者中抗CCP抗体阳性者四项指标均高于抗CCP抗体阴性者(P<0.05)。结论:抗CCP抗体诊断RA的灵敏度及特异度高,多项指标联合检测有助于RA诊断和鉴别诊断。Objective： To investigate the clinical value of anti-cyclic citrullinated peptide antibody （anti-CCP） combined with other three significant rheumatoid indicators of combined detection in the diagnosis of rheumatoid arthritis （RA） . Methods： A total of 78 cases of RA patients （RA group）, 72 cases of non-RA pantients with autoimmune diseases （non-RA group） and 75 cases of healthy persons （control group） were selected as subject. Anti-CCP antibody, rheumatoid factor （RF） and C-reactive protein （CRP） were detected by immune turbidimetric method, and erythrocyte sedimentation rate （ESR） were measured by Westergren to analyze its value in the diagnosis of RA. Results： Compared with the control group, the levels of anti-CCP antibody, RF, CRP and ESR in the RA group and non-RA group were significantly higher, the difference was statistically significant （P〈 0.05）, while compared with the non-RA group, only the levels of anti-CCP antibody and RF in the RA group were significantly increased （P〈0.05） . The sensitivity of the 4 indicators in the diagnosis of RA was 73.1% , 71.8% , 70.5% and 69.2% respectively, and the specificity was 91.7%, 88.9%, 52.8% and 50.0% respectively. When each indicator was individually used to diagnose the RA, the sensitivity and specificity of anti-CCP antibody were the highest, followed by RF, and those of ESR and CRP were the lowest. The levels of the 4 indicators in anti-CCP antibody -positive RA patients were significantly higher than those in the anti-CCP antibody-negative patients （P〈0.05） . Conclusion： Anti-CCP antibody shows high sensitivity and specificity in the diagnosis of RA, which combined with other 3 indicators can contribute to RA diagnosis and differential diagnosis.

关 键 词：类风湿关节炎 抗环瓜氨酸肽抗体 类风湿因子 C-反应蛋白 血沉 

分 类 号：R593.22[医药卫生—内科学]