抗氨基甲酰化蛋白抗体联合抗环瓜氨酸肽抗体诊断类风湿关节炎的价值  

Value of anti-CarP antibody combined with anti-CCP antibody in the diagnosis of rheumatoid arthritis

作　　者：薄娜娜 刘丹丹 张蓓 王伟远 吴沅皞[3] 李会强[1] BO Nana;LIU Dandan;ZHANG Bei(School of Medical Laboratory,Tianjin Medical University,Tianjin 300203,CHINA)

机构地区：[1]天津医科大学医学检验学院,300203 [2]天津中医药大学第一附属医院检验科 [3]天津中医药大学第一附属医院风湿免疫科

出　　处：《江苏医药》2022年第9期879-882,886,共5页Jiangsu Medical Journal

基　　金：国家自然科学基金(81772259)。

摘　　要：目的 探讨抗氨基甲酰化蛋白(CarP)抗体联合抗环瓜氨酸肽(CCP)抗体诊断类风湿关节炎(RA)的价值。方法 选取101例RA患者纳入RA组,35例非RA关节病变患者纳入疾病对照组,同期40例健康体检者纳入健康对照组。采用ELISA法测定三组抗CarP抗体和抗CCP抗体表达。分析抗CarP抗体和抗CCP抗体单独检测及并联试验诊断RA与临床诊断的一致性,通过四格表诊断试验分析诊断RA的准确性,ROC曲线分析抗CarP抗体和抗CCP抗体单独及联合检测诊断RA的价值。结果 RA组抗CCP抗体和抗CarP抗体表达高于疾病对照组和健康对照组(P<0.01)。抗CarP抗体和抗CCP抗体并联试验诊断RA与临床诊断的一致性较好(Kappa值=0.755,P<0.01),诊断RA的灵敏度和阴性预测值均提高。抗CarP抗体与抗CCP抗体联合检测诊断RA的AUC大于抗CarP抗体和抗CCP抗体单独检测(0.919 vs. 0.735和0.883)(P<0.05)。结论 抗CarP抗体在RA患者中高表达,其与抗CCP抗体并联试验诊断RA时具有较高的灵敏度和阴性预测值,有望成为诊断早期RA及判断预后的血清学补充指标。Objective To explore the clinical value of anti-carbamylated protein(CarP) antibody combined with anti-cyclic citrullinated peptide(CCP) antibody in the diagnosis of rheumatoid arthritis(RA).Methods A total of 136 patients were divided into two groups of A(with RA,101 cases) and B(without RA,35 cases).Forty healthy people undergoing physical examination were taken as the controls(group C).The expressions of anti-CarP antibody and anti-CCP antibody in three groups were detected by ELISA. The consistency between the diagnosis of RA and the clinical diagnosis of anti-CarP antibody and anti-CCP antibody detection alone and parallel test were analyzed by the four-table diagnostic test.ROC curves were used to analyze the value of anti-CarP antibody and anti-CCP antibody detection alone and in combination in the diagnosis of RA.Results The expressions of anti-CCP antibody and anti-CarP antibody in group A were higher than those in groups of B and C(P<0.01).The anti-CarP antibody and anti-CCP antibody parallel test in the diagnosis of RA was in a good agreement with the clinical diagnosis(Kappa value=0.755, P<0.01), and the sensitivity and negative predictive value of the diagnosis of RA were improved.The AUC of the combined detection of anti-CarP antibody and anti-CCP antibody in the diagnosis of RA was greater than that of anti-CarP antibody and anti-CCP antibody detection alone(0.919 vs. 0.735 and 0.883)(P<0.05). Conclusion Anti-CarP antibody is highly expressed in RA patients.The anti-CarP antibody and anti-CCP antibody parallel test has a higher sensitivity and negative predictive value in the diagnosis of RA. Anti-CarP antibody is expected to be a serological supplementary indicator for the early diagnosis and prognosis evaluation of the patients with RA.

关 键 词：类风湿关节炎 抗氨基甲酰化蛋白抗体 抗环瓜氨酸肽抗体 

分 类 号：R593[医药卫生—内科学]