| 类风湿性关节炎患者血清RA-CP，抗CCP 抗体及RF 检测对RA 的实验诊断意义 |
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| 引用本文： | 陈建芸a,廖海平a,孙朝晖a,李林海a,张宏斌b.类风湿性关节炎患者血清RA-CP，抗CCP 抗体及RF 检测对RA 的实验诊断意义[J].现代检验医学杂志,2020,0(5):38-40,50. |
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| 作者姓名： | 陈建芸a 廖海平a 孙朝晖a 李林海a 张宏斌b |
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| 作者单位： | 南部战区总医院a. 检验科；b. 医学实验科, 广州 510010 |
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| 摘 要： | 目的 分析不同血清类型的类风湿性关节炎（RA）患者血清中的类风湿性关节炎特异性抗原瓜氨酸化蛋白（RACP）
的水平，比较RA-CP 与抗环瓜氨酸多肽（CCP）抗体、类风湿因子（RF）在RA 诊断中的价值。方法 用酶联免疫
吸附法（ELISA）检测103 例RA 患者、71 例其他风湿病患者、105 例健康体检者血清中RA-CP，抗CCP 抗体和RF 的
水平。根据抗CCP 抗体和RF 测定结果将RA 患者分为4 种血清类型:抗CCP 抗体阳性/RF 阳性的RA、抗CCP 抗体
阳性/RF 阴性的RA、抗CCP 抗体阴性/RF 阳性的RA、抗CCP 抗体阴性/RF 阴性的RA，分析各种血清类型RA 患者
血清中RA-CP 的水平。结果 RA 组的血清中RA-CP 浓度水平中位数为4.51（1.80~7.49）单位，高于其他疾病组的0.53
（0.40~0.76）单位和健康对照组的0.52（0.35~0.69）单位。RA-CP，抗CCP 抗体和RF 对RA 的敏感度分别为77.7%，
65.0% 和69.9%，RA-CP 对RA 的敏感度高于抗CCP 抗体和RF（P ＜ 0.05）；特异度分别为95.5%，97.2% 和89.2%。在
4 种血清型的RA 中RA-CP 的检出率分别为100.0%（57/57），40.0%（4/10），100.0%（15/15）和19.0%（4/21）。在抗
CCP 抗体阴性的RA 中RA-CP 的检出率为52.8%（19/36）。结论 血清中RA-CP 对RA 的诊断比抗CCP 抗体和RF 具有
更高的敏感度，可提高类风湿性关节炎的检出率。因此RA-CP 可作为RA 临床诊断的新辅助指标。
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| 关 键 词： | 类风湿性关节炎特异性抗原瓜氨酸化蛋白 类风湿性关节炎 抗环瓜氨酸多肽抗体 类风湿因子 |
Significance of the Detection of RA-CP,Anti-CCP Antibody and
RF in the Laboratory Diagnosis of Rheumatoid Arthritis |
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| CHEN Jian-yuna,LIAO Hai-pinga,SUN Zhao-huia,LI Lin-haia,ZHANG Hong-binb.Significance of the Detection of RA-CP,Anti-CCP Antibody and
RF in the Laboratory Diagnosis of Rheumatoid Arthritis[J].Journal of Modern Laboratory Medicine,2020,0(5):38-40,50. |
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| Authors: | CHEN Jian-yuna LIAO Hai-pinga SUN Zhao-huia LI Lin-haia ZHANG Hong-binb |
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| Affiliation: | a.Department of Clinical Laboratory; b.Department of Medical Research, General Hospital of Southern Theater
Command, Guangzhou 510010,China |
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| Abstract: | Objective To analyze the level of the rheumatoid arthritis-specific citrullinated protein (RA-CP) in patients of
different serum types with rheumatoid arthritis (RA), and compare the value of RA-CP, anti-cyclic citrullinated polypeptide
(CCP) and rheumatoid factor (RF) in the diagnosis of RA. Methods Enzyme-linked immunosorbent assay (ELISA) was used
to detect the levels of RA-CP, anti-CCP antibodies and RF in the serum of 103 RA patients, 71 other rheumatism patients and 105
healthy person. According to the results of CCP and RF, RA patients were divided into 4 serotypes: anti-CCP antibody positive/
RF positive RA, anti-CCP antibody positive/RF negative RA, anti-CCP antibody negative/RF positive RA, anti-CCP antibodynegative/
RF-negative RA. The level of RA-CP in various serum types RA were test. Results The median RA-CP concentration
in serum of RA group was 4.51 (1.80 ~ 7.49) units, which was higher than 0.53 (0.40 ~ 0.76) units of other disease groups and 0.52
(0.35 ~ 0.69) units of healthy controls. The sensitivity of RA-CP, anti-CCP antibody and RF to RA was 77.7%, 65.0% and 69.9%
respectively and the sensitivity of RA-CP was higher than anti CCP antibody and RF(P ＜ 0.05). The specificity was 95.5%,
97.2% and 89.2% respectively. For the four serotypes of RA, RA-CP detection rates were 100.0% (57/57), 40.0% (4/10), 100.0%
(15/15) and 19.0% (4/21). Specially, in anti-CCP antibody negative RA group, the detection rate of RA-CP was 52.8% (19/36).
Conclusion RA-CP had higher sensitivity for the diagnosis of RA than anti-CCP antibody and RF, and RA-CP test could
improve the detection rate of rheumatoid arthritis. Therefore, RA-CP can be used as a new target for clinical diagnosis of RA. |
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