类风湿因子、抗环瓜氨酸肽抗体及肿瘤坏死因子-α表达对类风湿关节炎诊断及预后的意义  

Significance of diagnosis and prognosis with the expressing of rheumatoid factor, anti-CCP antibody and TNF-α in rheu matoid arthritis

作　　者：朱玉清 张莉萍[1] ZHU Yu-qing;ZHANG Li-ping(Clinical Laboratory,First Affiliated Hospital of Chongqing Medical University,Chongqing 400000,China)

机构地区：[1]重庆医科大学附属第一医院检验科,重庆400000

出　　处：《中国医学前沿杂志（电子版）》2018年第5期124-127,共4页Chinese Journal of the Frontiers of Medical Science(Electronic Version)

摘　　要：目的探讨类风湿因子(rheumatoid factors,RF)、抗环瓜氨酸肽抗体(抗CCP抗体)及肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)表达对类风湿关节炎(rheumatoid arthritis,RA)诊断及预后的意义,为RA的临床防治提供参考依据。方法选取2012年1月至2016年10月本院收治的89例RA患者纳入RA组,59例其他疾病患者纳入其他疾病组,另外选取同期于本院体检的105名健康者纳入健康对照组。检测三组患者的RF、抗CCP抗体、TNF-α、肿胀关节计数(swollen joint count,SJC)、压痛关节计数(tender joint count,TJC)、28个关节的疾病活动度(disease activity score 28,DAS28),计算RF、抗CCP抗体及TNF-α诊断RA的特异度、敏感度、阳性预测值、阴性预测值。结果 RA患者血清RF、抗CCP抗体及TNF-α水平均显著高于其他疾病患者及健康人群(P<0.05)。RF、抗CCP抗体及TNF-α对RA诊断的敏感度分别为83.15%、79.78%、76.40%,特异度分别为76.22%、92.68%、90.85%。RF的敏感度高于TNF-α及抗CCP抗体,而TNF-α的特异度、阳性预测值均高于RF,联合检测的敏感度有所下降,但特异度高于单独检测。RF、抗CCP抗体与DAS28呈显著正相关(P<0.05),TNF-α与SJC、TJC、DAS28均呈显著正相关(P<0.05)。结论 RF、抗CCP抗体及TNF-α在RA的早期诊断及预后评估中具有重要价值。Objective To discuss the significance of the expressing of rheumatoid factors,anti-CCP antibodies and TNF-αin rheumatoid arthritis'diagnosising and prognosising.Method From January 2012 to October 2016,89 cases of rheumatoid arthritis were included in the experimental group,59 cases of other rheumatoid immune diseases and 105 cases of normal physical examination were included in the control group during the same period in our hospital.Detected the RF,anti CCP antibody,TNF-α,swollen joint count(SJC),tender joint count(TJC),disease activity score 28(DAS28),calculated the specificity,sensitivity,positive predictive value,negative predictive value of RF,anti-CCP antibody and TNF-α.Result The level of RF,anti CCP antibody and TNF-αin RA patients is significantly higher than that of other connective tissue disease and healthy people.The sensitivity of diagnosis of RA were respective 83.15%,79.78%and 76.40%in RF,anti-CCP antibody and TNF-α,while the specific were respective 76.22%,92.68%,90.85%.The sensitivity of diagnosis of RA of RF is higher than that of anti-CCP antibody and TNF-α,while the specific and the positive predictive value in TNF-αwas higher than that of RF.The sensitivity of combine detection was lower than separate detection,while the specific was higher.The results of Pearson analysis showed that there was a significant positive correlation between RF,anti-CCP antibody level and DAS28,there were significant positive correlations between TNF-αlevel and SJC,TJC and DAS28(P<0.05).Conclusion RF,anti-CCP antibody and TNF-αhas high clinical value in the early diagnosis and prognosis evaluation of RA,it is worth of clinical promotion and application.

关 键 词：类风湿因子 抗CCP抗体 肿瘤坏死因子-Α 类风湿关节炎 

分 类 号：R593.22[医药卫生—内科学]