抗环瓜氨酸肽抗体抗RA33抗体类风湿因子抗体超敏C反应蛋白红细胞沉降率联合检测在类风湿关节炎中的诊断价值  

The combined detection of anti-cyclic citrulline peptide antibody,anti-rheumatoid arthritis 33 antibody,rheumatoid factor antibody,high-sensitivity C-reactive protein and red blood cell sedimentation rate in rheumatoid arthritis

作　　者：杨平平 Yang Pingping(Medical Laboratory Science,Xinxiang Medical University,Henan 453003,China)

机构地区：[1]河南省新乡医学院黄河三门峡医院医学检验科,453003

出　　处：《实用医技杂志》2021年第6期743-745,共3页Journal of Practical Medical Techniques

摘　　要：目的探究抗环瓜氨酸肽(CCP)抗体、抗RA33抗体、类风湿因子(RF)抗体、超敏-C反应蛋白(hs-CRP)以及红细胞沉降率(ESR)联合检测在类风湿关节炎(RA)中的诊断价值。方法选取2019年1月至12月在黄河三门峡医院诊断为RA的患者80例(RA组),诊断为非RA的其他自身免疫病患者76例(非RA组),健康对照者80名(对照组),采用化学发光法测定抗CCP抗体、抗RA33抗体和RF抗体,用免疫散射比浊法测定hs-CRP,用Roller 20全自动血沉仪测定ESR。结果RA组抗CCP抗体、抗RA33抗体、RF抗体、hs-CRP以及ESR水平均高于非RA组和健康对照组,差异有统计学意义(P<0.05)。抗CCP抗体、抗RA33抗体、RF抗体、hs-CRP、ESR对诊断RA的灵敏度分别为85.0%、78.8%、87.5%、75.0%、66.2%,特异度分别为96.0%、92.1%、76.3%、69.7%、68.4%。各指标单独检测时,抗CCP抗体具有较高的灵敏度和特异度。5项指标进行平行联检,诊断RA的灵敏度达到97.5%;5项指标进行系列联合,诊断RA的特异度达100%,高于各指标单项检测。抗CCP抗体、抗RA33抗体、RF抗体、hs-CRP、ESR曲线下的面积分别为0.949、0.881、0.944、0.861、0.851。联合抗CCP抗体、抗RA33抗体、RF抗体、hs-CRP、及ESR检测曲线下的面积为0.955。结论抗CCP抗体具有较高的灵敏度和特异度。五项指标联合检测明显提高了对RA的诊断效能。Objective To investigate the combined detection of anti-cyclic citrulline peptide(CCP)antibody,anti-RA33,rheumatoid factor(RF)antibody,high-sensitivity C-reactive protein(hs-CRP)and red blood cell sediment-ation rate erythrocyte sedimentation rate(ESR)in rheumatoid arthritis(RA).Methods Eighty patients with RA diagnosed in our hospital from January to December 2019(RA group),76 patients with non-RA other autoimmune diseases(non-RA group),and 80 healthy controls(control group)were selected.The anti-CCP antibody,RA33 anti-body,and RF antibody were measured by chemiluminescence method,the ultrasensitive CRP was measured by immuno-scattering turbidimetry method,and the ESR was measured by Roller 20 automatic erythrometer.Results The average levels of anti-CCP antibody,anti-RA33,RF antibody,hs-CRP and ESR in RA group were higher than those in non-RA group and healthy control group,and the differences were statistically significant(P<0.05).The sensitivity of anti-CCP antibody,anti-RA33,RF antibody,hs-CRP,and ESR to diagnosing RA was 85.0%,78.8%,87.5%,75.0%,and 66.2%,and specificities were 96.0%,92.1%,76.3%,69.7%,and 68.4%.When each indicator was tested separately,anti-CCP antibody had higher sensitivity and specificity.Five indicators were tested in parallel,and the sensitivity of diagnosis of RA reached 97.5%,the five indicators were combined in a series,and the specificity of diagnosis of RA reached 100%,which was significantly higher than the individual detection of each indicator.The area under the anti-CCP antibody,anti-RA33,RF antibody,hs-CRP,and red blood cell sedimentation rate(ESR)curves were 0.949,0.881,0.944,and 0.861,0.851,respectively.The area under the combined anti-CCP antibody,anti-RA33 antibody,RF antibody,hs-CRP,and ESR detection curves was 0.955.Conclusion Anti-CCP antibodies have higher sensitivity and specificity.The combined detection significantly improved the diagnostic efficacy of RA.

关 键 词：关节炎 类风湿 类风湿因子 C反应蛋白质 红细胞沉降率 

分 类 号：R593.22[医药卫生—内科学]