用受试者工作曲线评价抗环瓜氨酸肽抗体对诊断类风湿关节炎的价值

目的评价抗环瓜氨酸肽抗体(抗CCP抗体)在类风湿关节炎(RA)诊断中的价值。方法收集110例RA患者,与38例其他疾病患者以及36名正常人作为对照,应用受试者工作曲线(re-ceiveroperativecharacteristiccurve,ROC)分析软件评价抗CCP抗体在RA诊断中的价值,在ROC曲线上制定抗CCP抗体与类风湿因子(RF)各亚型在诊断RA中的最佳临界点。用四格表计算系列试验的特异度,进行统计学检验。用SPSS软件比较抗CCP抗体与RF各亚型之间的相关性。结果在诊断RA中,抗CCP抗体的ROC曲线下的面积(AUCROC)明显大于RF(IgA、IgM、IgG)AUCROC(P<0.01),抗CCP抗体联合任何一个RF亚型的系列试验的特异度高达100%。抗CCP抗体和RF(IgA、IgM、IgG)经Spearman相关分析,呈正相关。结论抗CCP抗体对RA有较高的诊断价值;诊断RA的系列试验中,含抗CCP抗体的系列试验的特异度高。

The research of anti-cyclic citrullinated peptide antibodies and rheumatoid factor in the diagnosis of rheumatoid arthritis

Objective To determine the diagnostic value of anti-cyclic citrullinated peptide antibodies (ACCP) for rheumatoid arthritis (RA). Methods Above antibodies were determined in 110 patients with RA, 38 non-RA patients and 36 normal peoples. The diagnostic value of ACCP was assessed and compared with rheumatoid factor (RF) by receiver operative characteristic curve (ROC) software. After determining the optimal cut-points of above indexes for RA, the specificity of serial tests for RA was calculated. The correlation between ACCP and immunoglobulin IgM, IgA, IgG RF was assessed by SPSS software. Results For diagnosis of RA, the area under ROC curve (AUCROC) of ACCP was significantly larger than that of IgA-RF, IgG-RF and IgM-RF (P<0.01). The specificity of serial tests of ACCP with IgA-RF, IgG-RF or IgM-RF was 100%. ACCP presented positive correlation with IgA-RF, IgG-RF and IgM-RF by Spearman relativity analysis. Conclusion ACCP is a valuable index for RA diagnosis. ACCP and IgA-RF, IgG-RF and IgM-RF has a positive correlationship. The combination of ACCP and RF may be useful in improving the diagnostic accuracy of RA.