2009082010216吴晓娜.docVIP

抗CCP抗体和RF联合检测在类风湿性关节炎中的诊断价值 吴晓娜1　张永良2　程建贞3 河北北方学院检验本科2班;2.中国人民解放军第251医院检验科3.河北北方学院免疫教研室) 【摘要】目的：探讨抗环瓜氨酸肽（CCP）抗体和类风湿因子（RF）在类风湿关节炎（RA）诊断中的价值。方法：采用胶体金免疫层析法检测169例RA患者及88例其他自身免疫性疾病患者（非RA组）血清中的抗CCP抗体，同时用免疫散射比浊法检测类风湿因子（RF）浓度，以54例同期健康体检者作为健康对照组。比较抗CCP抗体和RF对RA诊断的灵敏度、特异度、阳性预测值、阴性预测值、尤登指数，组间比较均采用χ2检验。结果：抗CCP抗体、RF在RA组患者血清中的阳性率分别为74.5%，76.9%，明显高于非RA组和健康对照组，差异有统计学意义（P0.05）；抗CCP抗体的灵敏度为74.5%，RF为76.9%，差异具有统计学意义（P0.05），两种抗体并联检测的灵敏度最高，两种抗体串联检测的特异度最高，与单独检测比较差异具有统计学意义（P0.05）；抗CCP抗体的阴性预测值和尤登指数最高；两种抗体串联检测的阳性预测值最高。结论：抗CCP抗体在RA诊断中具有较高的特异度，可作为诊断RA的理想血清学指标。两者联合检测可提高检测的灵敏度及特异度，从而降低漏诊率和误诊率，对RA的早期诊断具有更好的临床意义。 【关键词】抗CCP抗体，RF，类风湿关节炎 【ABSTRACT】Objective:To evaluate the clinical diagnostic value of anti-citrullinated peptide(anti-CCP) antibody and rheumatoid factor(RF) in patients with rheumatoid arthritis(RA). Methods:169 cases of patients with RA and 88 cases of patients with other autoimmune diseases(non-RA group) were detected for serum anti-CCP antibody by quantitative GICA and for RF by BNP nephelometry method. 36 healthy subjects were enrolled as healthy control group.Diagnostic sensitivity,specificity,positive predictive value,negative value and Youden index of anti-bodies and RF in RA were compared and comparison between groups is χ 2 test was used. Results:Anti-CCP antibodies and RF in RA group patients serum in the of positive rate respectively for 74.5%,76.9%, obviously above non-RA group and health controlled group and the difference was significant (P0.05); anti-CCP antibody of sensitivity for 74.5%,RF for 76.9%, the difference was significant (P0.05); two species antibody parallel detection of sensitivity Supreme, two species antibody series detection of specific degrees Supreme, and alone detection comparison differences has statistics meaning (P0.05) negative prediction value of anti-CCP antibodies and Youden index highest two-line detection of antibody positive predictive value is highest. Conclusion: anti-CCP antibody in the diagnosis of RA with high specificity, can be used as