血清RF、AKA、ANA、抗CCP抗体联合检测在类风湿关节炎诊断中的应用价值  

Application value of combined detection of serum RF,AKA,ANA and anti-CCP antibody in the diagnosis of rheumatoid arthritis

作　　者：王小杰 张美华 于宏亮 Wang Xiaojie;Zhang Meihua;Yu Hongliang(Department of Clinical Laboratory,Zhumadian Traditional Chinese Medicine Hospital,Zhumadian 463000,China;Department of Clinical Laboratory,the First People’s Hospital of Zhumadian,Zhumadian 463000,China)

机构地区：[1]驻马店市中医院检验科,驻马店463000 [2]驻马店市第一人民医院检验科,驻马店463000

出　　处：《中国实用医刊》2022年第19期80-83,共4页Chinese Journal of Practical Medicine

摘　　要：目的研究血清类风湿因子(RF)、抗角蛋白抗体(AKA)、抗核抗体(ANA)、抗环瓜氨酸肽(CCP)抗体联合检测在类风湿关节炎(RA)诊断中的价值。方法抽取2019年3月至2021年2月驻马店市中医院收治的RA患者68例作为研究组,并以1∶1配比抽取同期健康体检者68例作为对照组,检测两组RF、AKA、ANA、抗CCP抗体指标,以临床综合诊断结果为"金标准",统计4项指标单独和联合检测的诊断结果和诊断效能。结果研究组RF和抗CCP抗体水平均高于对照组(P均<0.05)。本组136例研究对象中,经临床综合诊断确诊阳性68例,阴性68例;RF诊断出真阳性43例,真阴性46例;AKA诊断出真阳性28例,真阴性64例;ANA诊断出真阳性17例,真阴性65例;抗CCP抗体诊断出真阳性47例,真阴性61例;四者联合诊断出真阳性67例,真阴性68例;四者联合诊断的灵敏度(98.53%,67/68)、特异度(100.00%,68/68)、准确度(99.26%,135/136)均高于RF(63.24%,43/68;67.65%,46/68;65.44%,89/136)、AKA(41.18%,28/68;94.12%,64/68;67.65%,92/136)、ANA(25.00%,17/68;95.59%,65/68;60.29%,82/136)及抗CCP抗体(69.12%,47/68;89.71%,61/68;79.41%,108/136)诊断(P均<0.05),四者联合诊断漏诊率(1.47%,1/68)、误诊率(0.00%,0/68)均低于RF(36.76%,25/68;32.35%,22/68)、AKA(58.82%,40/68;5.88%,4/68)、ANA(75.00%,51/68;4.41%,3/68)及抗CCP抗体(30.88%,21/68;10.29%,7/68)诊断(P均<0.05)。结论RF、AKA、ANA、抗CCP抗体联合检测应用于RA诊断中,可提升诊断灵敏度和准确度,减少漏诊情况的发生,有利于RA早期诊断,为临床治疗提供参考依据。Objective To study the value of combined detection of serum rheumatoid factor(RF),anti-keratin antibody(AKA),anti-nuclear antibody(ANA)and anti-cyclic citrullinated peptide(CCP)antibody in the diagnosis of rheumatoid arthritis(RA).Methods A total of 68 RA patients treated in Zhumadian Traditional Chinese Medicine Hospital from March 2019 to February 2021 were selected as the study group,and 68 healthy subjects were selected as the control group with a 1∶1 ratio.RF,AKA,ANA and anti-CCP antibody of the two groups were detected.Taking the comprehensive clinical diagnosis results as the gold standard,the diagnostic results and diagnostic efficacy of the four indicators and combination of them were counted.Results The levels of RF and anti-CCP antibody in the study group were higher than those in the control group(all P<0.05).Among the 136 subjects in this study,68 cases were positive,and 68 cases were negative diagnosed by clinical comprehensive diagnosis;43 cases were true positive,and 46 cases were true negative diagnosed by RF;28 cases were true positive,and 64 cases were true negative diagnosed by AKA;17 cases were true positives,and 65 cases were true negatives diagnosed by ANA;47 cases were true positives,and 61 cases were true negatives diagnosed by anti-CCP antibody;67 cases were true positives,and 68 cases were true negatives diagnosed by the combination of the four indicators.The sensitivity,specificity and accuracy of the combined diagnosis were 98.53%(67/68),100.00%(68/68)and 99.26%(135/136),respectively,higher than those of RF(63.24%,43/68;67.65%,46/68;65.44%,89/136),AKA(41.18%,28/68;94.12%,64/68;67.65%,92/136),ANA(25.00%,17/68;95.59%,65/68;60.29%,82/136)and anti-CCP antibody(69.12%,47/68;89.71%,61/68;79.41%,108/136),all P<0.05.The rate of missed diagnosis and misdiagnosis of the combined diagnosis were 1.47%(1/68),0.00%(0/68),respectively,lower than those of RF(36.76%,25/68;32.35%,22/68),AKA(58.82%,40/68;5.88%,4/68),ANA(75.00%,51/68;4.41%,3/68)and anti-CCP antibody(30.88%,21/68;10.29%,7/68),all P<0.05

关 键 词：类风湿关节炎 类风湿因子 抗角蛋白抗体 抗核抗体 抗环瓜氨酸肽抗体 

分 类 号：R593.22[医药卫生—内科学]