血清类风湿因子、抗环瓜氨酸肽抗体、红细胞沉降率在类风湿关节炎联合诊断中的应用价值  

To investigate the application value of serum rheumatoid factor,anti-cyclic citrullinated peptide antibody and erythrocyte sedimentation rate in the combined diagnosis of rheumatoid arthritis

作　　者：朱香琴 高敏[1] ZHU Xiangqin;GAO Min(Clinical Laboratory,Huzhou Central Hospital in Zhejiang Province,Huzhou 313000,Zhejiang,China)

机构地区：[1]浙江省湖州市中心医院检验科,浙江湖州313000

出　　处：《中国现代医生》2024年第17期34-37,共4页China Modern Doctor

基　　金：2021年浙江省湖州市科学技术局公益性应用研究-医卫一般项目(2021GYB32)。

摘　　要：目的探讨类风湿因子(rheumatoid factor,RF)、抗环瓜氨酸肽抗体(anti-cyclic citrullinated peptide,anti-CCP)以及红细胞沉降率(erythrocyte sedimentation rate,ESR)联合检测在类风湿关节炎(rheumatoid arthritis,RA)中的应用价值。方法选取2022年1月至2023年1月于笔者医院诊断为RA的患者70例作为RA组,诊断为其他自身免疫性疾病患者60例作为非RA组。另选取同期体检的50例健康人员作为对照组。利用免疫比浊法检测RF,利用化学发光法检测抗CCP抗体,利用魏氏法原理测定ESR,比较各指标单独及联合检测的诊断结果,绘制受试者操作特征(receiver operating characteristic,ROC)曲线判断指标的诊断价值。结果RA组RF和抗CCP抗体水平明显高于非RA组和对照组,差异有统计学意义(P<0.05)。RA组ESR水平明显高于对照组,差异有统计学意义(P<0.05),可与非RA组比较差异无统计学意义(P>0.05)。血清RF、抗CCP抗体和ESR联合检测的敏感度、特异性、阳性预测值、阴性预测值分别为57.14%、99.09%、97.56%、76.22%。3者联合检测的特异性及阳性预测值明显高于单独检测值,差异有统计学意义(P<0.05)。ROC曲线显示3者指标联合检测的曲线下面积可达0.913,诊断价值最高。结论血清RF、抗CCP抗体、ESR联合诊断的特异性和阳性预测值最高,有利于类风湿关节炎的诊断及治疗。Objective To explore the diagnostic value of combined detection of rheumatoid factor(RF),anti-cyclic citrullinated peptide(CCP)antibody and erythrocyte sedimentation rate(ESR)in rheumatoid arthritis(RA).Methods From January 2022 to January 2023,70 patients diagnosed with RA in our hospital as the RA group,60 patients diagnosed with other autoimmune diseases without RA as the non RA group.Fifty individuals with normal physical examination indicators as the control group.RF was detected by immunoturbidimetric method,anti-CCP antibody was detected by chemiluminescence method,and ESR was determined by Weil’s method principle,the diagnostic results of individual and combined detection of each indicator were compared,and the diagnostic value of the indicator was determined by drawing receiver operating characteristic(ROC)curve.Results In all three groups,the concentrations of RF and anti-CCP antibodies were highest in the RA group,with significant differences(P<0.05).The ESR concentration in the control group was lower than that in the RA group,with a significant difference(P<0.05).But there was no significant difference compared with non-RA group(P>0.05).The combined detection of RF,anti-CCP antibody and ESR,sensitivity were 57.14%,specificity were 99.09%,positive predictive value were 97.56%and negative predictive value were 76.22%.The specificity and positive predictive value of the combined detection of RF,anti-CCP antibody and ESR were significantly higher than those of the single detection,and the difference was statistically significant(P<0.05).The ROC curve graph shows that the area under the curve of the combined detection of the three indexes can reach 0.913,which is the highest diagnostic value.Conclusion The combined diagnosis of RF,anti-CCP antibody and ESR has high specificity and positive predictive value,which is beneficial to the diagnosis and treatment of clinical diseases.

关 键 词：类风湿关节炎 类风湿因子 抗环瓜氨酸肽抗体 红细胞沉降率 

分 类 号：R593[医药卫生—内科学]