抗CCP抗体联合免疫球蛋白型类风湿因子在类风湿关节炎诊断中的意义及临床价值  

The Significance and clinical Value of anti-CCP Antibody combined with Immunoglobulin Rheumatoid Factor in the Diagnosis of Rheumatoid Arthritis

作　　者：李玮 王慧芳 成守金 LI Wei;WANG Huifang;CHENG Shoujin(Inspection Department,Henan Jiaozuo Coal Industry(Group)Co.Ltd.Central Hospital,Jiaozuo Henan 454000,China)

机构地区：[1]河南省焦作煤业(集团)有限责任公司中央医院检验科,河南焦作454000

出　　处：《临床研究》2024年第3期37-40,共4页Clinical Research

摘　　要：目的探讨抗环瓜氨酸多肽(CCP)抗体、免疫球蛋白A型类风湿因子(IgA-RF)、免疫球蛋白G型类风湿因子(IgG-RF)、免疫球蛋白M型类风湿因子(IgM-RF)在类风湿关节炎(RA)诊断中的意义。方法选取河南省焦作煤业(集团)有限责任公司中央医院2022年1月至2023年1月收治的80例RA患者作为RA组,选取80例同期其他结缔组织疾病患者作为其他结缔组织疾病组,另选取80例健康体检者作为对照组。比较三组研究对象抗CCP抗体、IgA-RF、IgG-RF、IgM-RF阳性率和血清浓度,比较不同病情活动度RA患者各指标浓度,分析各项指标对RA的诊断价值。结果RA组抗CCP抗体、IgA-RF、IgG-RF、IgM-RF阳性率和血清浓度均高于其他结缔组织疾病组和对照组,差异均有统计学意义(P<0.05),其他结缔组织疾病组高于对照组,差异均有统计学意义(P<0.05);高活动度组血清IgA-RF高于中低活动度组,差异具有统计学意义(P<0.05);四项指标联合检测诊断的敏感度高于各项指标单独检测(χ^(2)=12.877、8.581、60.210、4.838,P<0.05);联合检测特异度高于IgM-RF单独检测(χ^(2)=26.883,P<0.05);联合检测准确度高于各项指标单独检测(χ^(2)=45.926、34.592、6.176、12.625,P<0.05);联合检测阳性预测值高于IgA-RF、IgG-RF、IgM-RF单独检测(χ^(2)=3.888、6.365、21.671,P<0.05);联合检测阴性预测值高于各项指标单独检测(χ^(2)=9.497、7.402、33.961、6.117,P<0.05)。结论抗CCP抗体、IgA-RF、IgG-RF、IgM-RF联合诊断RA的价值较高,其中IgA-RF可能与疾病活动性有关。Objective To explore the significance of anti-cyclic citrullinated peptide(CCP)antibodies,immunoglobulin A rheumatoid factor(IgA-RF),immunoglobulin G rheumatoid factor(IgG-RF),and immunoglobulin M rheumatoid factor(IgM-RF)in the diagnosis of rheumatoid arthritis(RA).Methods A total of 80 RA patients admitted to the Central Hospital of Jiaozuo Coal Industry(Group)Co.Ltd.in Henan Province from January 2022 to January 2023 were selected as the RA group,80 patients with other connective tissue diseases during the same period were selected as the other connective tissue disease group,and an additional 80 healthy examinees were selected as the control group.The positive rates and serum concentrations of anti-CCP antibodies,IgA-RF,IgG-RF,and IgM-RF among three groups of study subjects were compared,the concentrations of various indicators in RA patients with different disease activity levels were compared,and the diagnostic value of each indicator for RA was analyzed.Results The positive rates and serum concentrations of anti-CCP antibodies,IgA-RF,IgG-RF,and IgM-RF in the RA group were higher than those in other connective tissue disease groups and the control group,with statistical significance(P<0.05).The other connective tissue disease groups were higher than the control group,with statistical significance(P<0.05);The serum IgA-RF in the high activity group was higher than that in the medium low activity group,and the difference was statistically significant(P<0.05);The sensitivity of joint detection and diagnosis of four indicators is higher than that of individual detection of each indicator,the difference was statistically significant(χ^(2)=12.877,8.581,60.210,4.838,P<0.05);Joint detection has higher specificity than IgM-RF alone detection,the difference was statistically significant(χ^(2)=26.883,P<0.05);Joint testing has higher accuracy than individual testing for various indicators,the difference was statistically significant(χ^(2)=45.926,34.592,6.176,12.625,P<0.05);The positive predictive value of joint test

关 键 词：类风湿关节炎 免疫球蛋白型 类风湿因子 抗环瓜氨酸多肽抗体 临床价值 

分 类 号：R593.22[医药卫生—内科学]