抗突变型瓜氨酸波形蛋白抗体对类风湿关节炎的诊断价值  

Diagnostic value of anti-mutated citrullinated vimentin antibody in rheumatoid arthritis

作　　者：张小云[1] 潘胜男 连建春 ZHANG Xiaoyun;PAN Shengnan;LIAN Jianchun(Department of Clinical Laboratory,the Affiliated Huai’an No.1 People’s Hospital of Nanjing Medical University,Huai’an 223021,Jiangsu,China)

机构地区：[1]南京医科大学附属淮安第一医院检验科,江苏淮安223021

出　　处：《中国现代医生》2023年第34期37-40,共4页China Modern Doctor

摘　　要：目的探讨抗环瓜氨酸肽抗体(anti-cyclic citrullinated peptide antibody,抗CCP抗体)、抗突变型瓜氨酸波形蛋白抗体(anti-mutated citrullinated vimentin antibody,抗MCV抗体)和25-羟维生素D[25-hydroxyvitamin D,25(OH)D]在类风湿关节炎(rheumatoid arthritis,RA)中的临床诊断价值。方法选取2016年8月至2021年11月南京医科大学附属淮安第一医院收治的466例RA患者纳入RA组,非RA的其他自身免疫性疾病及代谢性疾病患者100例纳入非RA组,健康体检者100人纳入对照组,检测三组受试者的血清抗CCP抗体、抗MCV抗体和25(OH)D水平,绘制受试者操作特征曲线分析抗CCP抗体、抗MCV抗体、25(OH)D对RA的诊断效能,分析RA患者抗MCV抗体与各临床指标的相关性。结果RA组患者的血清抗MCV抗体和抗CCP抗体显著高于非RA组和对照组(P<0.05);RA组患者的血清25(OH)D水平显著低于对照组(P<0.05);抗CCP抗体、抗MCV抗体及25(OH)D诊断RA的曲线下面积(area under the curve,AUC)分别为0.74、0.81和0.75,三项联合诊断RA的AUC为0.90,敏感度为83.70%,特异性为82.40%。抗MCV抗体与红细胞沉降率、C反应蛋白均呈正相关(r=0.66、0.64,P<0.05),与补体C3、C4均呈负相关(r=–0.69、–0.62,P<0.05)。结论抗CCP抗体、抗MCV抗体和25(OH)D诊断RA均有较好的敏感度和特异性,抗MCV抗体有助于RA疾病活动性的判断。Objective To investigate the clinical diagnostic value of anti-cyclic citrullinated peptide(CCP)antibody,anti-mutated citrullinated vimentin(MCV)antibody and 25-hydroxyvitamin D[25-(OH)D]in rheumatoid arthritis(RA)patients.Methods A total of 466 patients with RA who were admitted the Affiliated Huai’an No.1 People’s Hospital of Nanjing Medical University from August 2016 to November 2021 were included in RA group,100 patients with other autoimmune diseases and metabolic diseases without RA were included in non-RA group,100 healthy subjects were included in control group.Serum anti-CCP antibody,anti-MCV antibody and 25(OH)D were detected in three groups.Receiver operating characteristic curve was drawn to analyze the diagnostic efficacy of anti-CCP antibody,anti-MCV antibody and 25(OH)D in RA.The correlation between anti-MCV antibody and clinical indexes in RA patients was analyzed.Results Serum anti-MCV antibody and anti-CCP antibody in RA group were significantly higher than those in non-RA group and control group(P<0.05).The serum 25(OH)D level in RA group was significantly lower than that in control group(P<0.05).The area under the curve(AUC)of anti-CCP antibody,anti-MCV antibody and 25(OH)D for the diagnosis of RA were 0.74,0.81 and 0.75,respectively.The AUC for the combined diagnosis of RA was 0.90,the sensitivity was 83.70%,and the specificity was 82.40%.Anti-MCV antibody was positively correlated with erythrocyte sedimentation rate and C-reactive proten(r=0.66,0.64,P<0.05),and negatively correlated with complement C3 and C4(r=–0.69,–0.62,P<0.05).Conclusion Anti-CCP antibody,anti-MCV antibody and 25(OH)D have good sensitivity and specificity for the diagnosis of RA,and anti-MCV antibody was helpful for the diagnosis of the disease activity.

关 键 词：类风湿关节炎 抗CCP抗体 抗MCV抗体 25-羟维生素D 

分 类 号：R446[医药卫生—诊断学]