类风湿因子亚型、抗CCP和抗RA33联合检测在早期类风湿关节炎诊断中的应用价值  

Application Values of the Combined Detection of Rheumatoid Factor Subtypes,Anti-CCP and Anti-RA33 in the Early Diagnosis of Rheumatoid Arthritis

作　　者：任春锋[1] REN Chunfeng(Department of Clinical Laboratory,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,China)

机构地区：[1]郑州大学第一附属医院检验科,河南郑州450000

出　　处：《河南医学研究》2024年第8期1419-1422,共4页Henan Medical Research

摘　　要：目的探讨血清类风湿因子(RF)亚型(包括IgG-RF、IgA-RF、IgM-RF)、抗CCP、抗RA33联合检测在早期类风湿关节炎(RA)诊断中的意义。方法收集2021年6月至2022年5月医院收治的可疑RA患者作为研究对象,根据临床诊断结果将患者分为RA组(135例)和非RA组(1556例),测定两组血清IgG-RF、IgA-RF、IgM-RF、抗CCP、抗RA33水平,比较各项指标阳性表达情况,分析联合检测的诊断效能。结果RA组IgG-RF、IgA-RF、IgM-RF、抗CCP、抗RA33水平均高于非RA组(P<0.05);单项指标中,灵敏度和正确指数最高的是抗CCP,特异性最高的是IgG-RF;抗RA33灵敏度最低但特异性比较高。联合检测中以只要有阳性为判断标准,灵敏度和正确指数增加,灵敏度最高的是RF亚型/抗CCP/抗RA33(为99.26%),其次是RF亚型/抗CCP(95.56%);正确指数最高的是RF亚型/抗CCP/抗RA33(78.57%),其次是RF亚型/抗CCP(78.52%)。如果以联合检测中所有项目均阳性为判断标准,特异性明显升高,特异性最高的是RF亚型+抗CCP+抗RA33(99.55%),其次是RF亚型+抗RA33(98.78%)。结论RF亚型、抗CCP和抗RA33等指标对RA诊断具有一定价值,这些指标联合检测可以提高诊断灵敏度、特异性,提高早期诊断效能。Objective To explore the significance of the combined detection of rheumatoid factor(RF)subtybes(including IgG-RF,IgA-RF,IgM-RF),anti-CCP and anti-RA33 in the early diagnosis of rheumatoid arthritis(RA).Methods Patients with suspected RA admitted to the hospital from June 2021 to May 2022 were collected as research objects.According to the clinical diagnosis results,the patients were divided into RA group(135 cases)and non-RA group(1556 cases).The levels of serum IgG-RF,IgA-RF,IgM-RF,anti-CCP,anti-RA33 in the two groups were measured,and the positive expression of each index was compared,and the diagnostic efficacy of the combined test was analyzed.Results The levels of IgG-RF,IgA-RF,IgM-RF,anti-CCP and anti-RA33 in RA group were higher than those in non-RA group(P<0.05).Among the single indexes,the anti-CCP had the highest sensitivity and accuracy index,while the IgG-RF had the highest specificity.The sensitivity of anti-RA33 was the lowest,but the specificity was relatively high.In the combined detection,as long as there was a positive result,it was used as the judgment criterion,the diagnostic sensitivity and accuracy index increased.The highest diagnostic sensitivity was RF subtypes/anti-CCP/anti-RA33(99.26%),followed by RF subtypes/anti-CCP(95.56%).The highest accuracy index was found in RF subtypes/anti-CCP/anti-RA33(78.57%),followed by RF subtypes/anti-CCP(78.52%).If all items in the combined detection were positive as the judgment criterion,the diagnostic specificity significantly increased.The highest diagnostic specificity was RF subtypes+anti-CCP+anti-RA33(99.55%),followed by RF subtypes+anti-RA33(98.78%).Conclusion There is certain diagnostic value of RF subtypes,anti-CCP and anti-RA33 for RA.Combined detection with these indexes can improve diagnostic sensitivity,specificity,and early diagnostic efficiency for RA.

关 键 词：类风湿关节炎 抗CCP抗体 类风湿因子 抗RA33抗体 

分 类 号：R684.3[医药卫生—骨科学]