抗CCP抗体和抗MCV抗体等多种检测对类风湿性关节炎的诊断价值  

Determinations of anti-CCP antibody and anti-MCV antibody for the diagnosis of rheumatoid arthritis

作　　者：赵万辉[1] 王泽筠[1] 亓琳[1] 耿丽丽 张璐璐[1] 刘义庆[1] 许瑞[1] 

机构地区：[1]山东大学附属省立医院临床医学检验部,山东济南250021

出　　处：《检验医学》2017年第11期975-978,共4页Laboratory Medicine

基　　金：山东省自然科学基金项目(ZR2014HP043);山东省临床重点专科建设项目(鲁卫医字[2013]26号)

摘　　要：目的探讨抗环瓜氨酸多肽(CCP)抗体、抗类风湿性关节炎蛋白33(RA33)抗体、抗葡萄糖6磷酸异构酶(GPI)抗体、抗突变型瓜氨酸波形蛋白(MCV)抗体、类风湿因子(RF)及其亚型、红细胞沉降率(ESR)对类风湿性关节炎(RA)的临床诊断价值。方法选取经临床确诊的RA患者165例、非RA结缔组织病患者120例、体检健康者80名,分别检测其血清抗CCP抗体、抗RA33抗体、抗GPI抗体、抗MCV抗体、RF-IgA、RF-IgG、RF-IgM、RF及ESR水平,并对结果进行统计分析。结果诊断RA的敏感性分别为抗CCP抗体85.4%、抗RA33抗体11.0%、抗GPI抗体67.2%、抗MCV抗体84.0%、RF-IgA 82.4%、RF-IgG 17.0%、RF-IgM83.6%、RF 87.8%、ESR 81.8%,特异性分别为抗CCP抗体95.0%、抗RA33抗体98.3%、抗GPI抗体83.3%、抗MCV抗体90.0%、RF-IgA 91.6%、RF-IgG 95.8%、RF-IgM 70.8%、RF 83.3%、ESR 70.8%。抗CCP抗体和抗MCV抗体联合检测的敏感性和特异性分别为98.8%和96.7%。结论抗CCP抗体和抗MCV抗体是对RA有较高诊断价值的血清学标志物,与抗RA33抗体、抗GPI抗体、RF-IgA、RF-IgG、RF-IgM、RF及ESR的检测结果相结合,可提高对RA的诊断率,有助于RA的临床诊断。Objective To investigate the roles of anti-cyclic citrullinated peptide（CCP） antibody,anti-rheumatoid arthritis 33（RA33） antibody,anti-glucose-6-phosphate isomerase（GPI） antibody,anti-mutated citrullinated vimentin（MCV） antibody,rheumatoid factor（RF）,RF subtypes and erythrocyte sedimentation rate（ESR）for the diagnosis of rheumatoid arthritis（RA）. Methods A total of 165 patients with RA and 120 patients with mixed connective tissue disease were enrolled. A total of 80 healthy subjects were enrolled as healthy control group. Serum anti-CCP,anti-RA33,anti-GPI and anti-MCV antibodies,RF-IgA,RF-IgG,RF-IgM,RF and ESR were determined. Results The sensitivities of anti-CCP,anti-RA33,anti-GPI and anti-MCV antibodies,RF-IgA,RF-IgG,RF-IgM,RF and ESR in RA group were 85.4%,11.0%,67.2%,84.0%,82.4%,17.0%,83.6%,87.8% and 81.8%,respectively. Their speci？cities were 95.0%,98.3%,83.3%,90.0%,91.6%,95.8%,70.8%,83.3% and 70.8%,respectively. The sensitivity and speci？city of the combined determination of anti- CCP antibody and anti-MCV antibody were 98.8% and 96.7% in RA group. Conclusions Anti-CCP and anti-MCV antibodies can be biomarkers for the diagnosis of RA. Combining the results of anti-RA33 and anti-GPI antibodies,RF-IgA,RF-IgG,RF-IgM,RF and ESR,the diagnosis of RA can be improved.

关 键 词：抗环瓜氨酸多肽抗体 抗类风湿性关节炎蛋白33抗体 抗葡萄糖6磷酸异构酶抗体 抗突变型瓜氨酸波形蛋白抗体 类风湿因子 红细胞沉降率 类风湿性关节炎 

分 类 号：R446.62[医药卫生—诊断学]