类风湿性关节炎患者血清抗Sa抗体、AKA、抗CCP抗体的检测意义探讨  

Detection significance of serum anti-Sa antibody, AKA and anti-CCP antibody in patients with rheumatoid arthritis

作　　者：陈静娴[1] 范见佩 张少芬[3] 李钦 CHEN Jing-xian;FAN Jian-pei;ZHANG Shao-fen(Department of Laboratory Medicine,Wuchuan People's Hospital,Wuchuan 524500,China)

机构地区：[1]吴川市人民医院检验科,524500 [2]吴川市妇幼保健院检验科,524500 [3]南方医科大学南方医院检验科,510515

出　　处：《中国实用医药》2022年第18期107-110,共4页China Practical Medicine

基　　金：湛江市科技计划项目(项目编号:2021B01323)。

摘　　要：目的 探讨类风湿性关节炎(RA)患者血清抗Sa抗体、抗角蛋白抗体(AKA)、抗环瓜氨酸抗体(抗CCP抗体)的检测意义。方法 150例疑似RA患者,均检测类风湿因子(RF),血清抗Sa抗体、AKA、抗CCP抗体,以关节镜检查结果及临床诊断标准为金标准,分析RF、抗Sa抗体、AKA、抗CCP抗体对RA患者的诊断价值。结果 关节镜检查及临床诊断显示:RA 100例,非RA 50例(系统性红斑狼疮20例、干燥综合征16例、多发性肌炎/皮肌炎14例)。RF诊断RA敏感度为75.00%,特异度为78.00%,准确度为76.00%, Kappa值为0.495;抗Sa抗体敏感度为36.00%,特异度为94.00%,准确度为55.33%, Kappa值为0.553;AKA敏感度为66.00%,特异度为80.00%,准确度为70.67%, Kappa值为0.411;抗CCP抗体敏感度为78.00%,特异度为86.00%,准确度为80.67%, Kappa值为0.595。RF+抗Sa抗体诊断RA敏感度为34.00%,特异度为94.00%,准确度为54.00%, Kappa值为0.213;RF+AKA诊断RA敏感度为65.00%,特异度为82.00%,准确度为70.67%, Kappa值为0.416;RF+抗CCP抗体诊断RA敏感度为73.00%,特异度为88.00%,准确度为78.00%, Kappa值为0.552;抗Sa抗体+AKA+抗CCP抗体联合检测诊断RA敏感度为30.00%,特异度为96.00%,准确度为52.00%, Kappa值为0.194;RF+抗Sa抗体+AKA+抗CCP抗体联合检测诊断RA敏感度为34.00%,特异度为98.00%,准确度为55.33%, Kappa值为0.242。结论 单项抗体检测具有一定局限性,多项抗体联合检测可提高RA的临床确诊率,其中以抗CCP抗体联合RF最具有诊断价值。Objective To discuss the detection significance of serum anti-Sa antibody, anti-keratin antibody(AKA) and anti-cyclic citrullinated peptide antibody(anti-CCP antibody) in patients with rheumatoid arthritis(RA). Methods 150 patients with suspected RA were detected for rheumatoid factor(RF), serum antiSa antibody, AKA, and anti-CCP antibody, and the diagnostic value of RF, anti-Sa antibody, AKA, and antiCCP antibody for RA patients was analyzed using arthroscopic findings and clinical diagnostic criteria as the gold standard. Results Arthroscopy and clinical diagnosis showed 100 cases of RA and 50 cases of non-RA(20 cases of systemic lupus erythematosus, 16 cases of Sjogren’s syndrome, and 14 cases of polymyositis/dermatomyositis).For the diagnosis of RA, the sensitivity of RF was 75.00%, the specificity was 78.00%, the accuracy was 76.00%,and the Kappa value was 0.495;the sensitivity of anti-Sa antibody was 36.00%, the specificity was 94.00%, the accuracy was 55.33%, and the Kappa value was 0.553;the sensitivity of AKA was 66.00%, the specificity was 80.00%, the accuracy was 70.67%, and the Kappa value was 0.411;the sensitivity of anti-CCP antibody was 78.00%, the specificity was 86.00%, the accuracy was 80.67%, and the Kappa value was 0.595. For the diagnosis of RA, the sensitivity of RF combined with anti-Sa antibody was 34.00%, the specificity was 94.00%, the accuracy was 54.00%, and the Kappa value was 0.213;the sensitivity of RF combined with AKA was 65.00%, the specificity was 82.00%, the accuracy was 70.67%, and the Kappa value was 0.416;the sensitivity of RF combined with anti-CCP antibody was 73.00%, the specificity was 88.00%, the accuracy was 78.00%, and the Kappa value was 0.552;the sensitivity of combined detection of anti-Sa antibody, AKA and anti-CCP antibody was 30.00%,the specificity was 96.00%, the accuracy was 52.00%, and the Kappa value was 0.194;the sensitivity of combined detection of RF, anti-Sa antibody, AKA and anti-CCP antibody was 34.00%, the specificity was 98.00%, the accuracy was 55

关 键 词：类风湿性关节炎 血清抗Sa抗体 抗角蛋白抗体 抗环瓜氨酸抗体 

分 类 号：R593.22[医药卫生—内科学] R446.6[医药卫生—临床医学]