联合检测抗CCP抗体AKA与RF对类风湿性关节炎早期诊断意义.docVIP

联合检测抗CCP抗体AKA与RF对类风湿性关节炎早期诊断意义 　　[摘要] 目的:探讨联合检测抗环瓜氨酸肽抗体(anti-CCP)、抗角蛋白抗体(AKA)与类风湿因子(RF)对类风湿性关节炎(RA)早期诊断的意义。方法:采用酶联免疫吸附法(ELASA)检测anti-CCP,采用间接免疫荧光法检测AKA,采用速率散射比浊法检测RF。结果:RF、anti-CCP、AKA 在RA组的阳性率分别为88.75%、86.25%、67.50%,在对照组的阳性率分别为39.22%、15.69%、25.49%,实验组均高于对照组(P0.01)。三者对诊断RA的灵敏度和特异度分别为anti-CCP:86.25%,88.73%;AKA:67.5%,81.69%;RF:88.75%,71.83%。三者联合检测特异度可达94.37%,阳性预测值可达92.60%。结论:anti-CCP具有较好的灵敏度和特异度;联合检测anti-CCP、AKA与RF可明显提高对类风湿性关节炎早期诊断的特异性。 　　[关键词] 类风湿性关节炎;抗环瓜氨酸肽抗体;抗角蛋白抗体;类风湿因子 　　[中图分类号] R446.6[文献标识码]A [文章编号]1673-7210(2009)07(a)-032-03 　　 　　Evaluation of anti-cyclic citrullinated peptide antibody、anti-keratin antibody and rheumatoid factor in diagnosis of early rheumatoid arthritis 　　LI Xiuhong, ZHANG Caiji 　　(Laboratory Medicine Center, Yantai Yuhuangding Hospital, Yantai264000, China) 　　[Abstract] Objective: To explore the diagnostic significance of rheumatoid factor(RF) anti-keratin antibody(AKA) and anti-cyclic citrullinated peptide antibody(anti-CCP) in rheumatoid arthritis(RA) patients. Methods: RF,anti-CCP and AKA were detected by rate nephelometry method, ELISA and indirect immunofluorescence(IIF) respectively from 80 patients with RA and 71 with non-RA. Results: The positive rates of RF, anti-CCP and AKA in RA group (88.75%, 86.25%, 67.50%) were higher than those in control group (39.22%, 15.69%, 25.49%) (P0.01). Especially, three of these autoantibodies can improve the specificity and the positive predictive value. Conclusion: Anti-CCP has relatively higher sensitivity and specificity in the diagnosis of early rheumatoidarthritis. The combined detection of anti-CCP, AKA and RF can improve the specificity of diagnosis of early RA. 　　[Key words] Rheumatoid arthritis; Anti-cyclic citrullinated peptide antibody; Anti-keratin antibody; Rheumatoid factor 　　 　　类风湿性关节炎(rheumatoidarthritis,RA)是一种致畸性系统性自身免疫性疾病[1],主要表现为关节肿痛,晚期发生强直、畸形及功??障碍,并可引起多种并发症,是临床上常见而多发的难治性关节运动性疾病之一。在我国发病率为0.32%～0.40%[2],是造成我国劳动者致残的主要病因之一。早期诊断类风湿性关节炎是对其进行治疗和预后的关键。长期以来,大多以类风湿因子(RF)作为一个比较重要