联合检测类风湿因子、抗环瓜氨酸多肽抗体和抗角蛋白抗体在类风湿关节炎诊断中的价值

目的：研究类风湿因子（RF）、抗环瓜氨酸多肽（CCP）抗体和抗角蛋白抗体（AKA）联合检测在类风湿关节炎（RA）诊断中的价值。方法：分别应用免疫比浊法、ELISA法和间接免疫荧光染色法检测150例RA患者和75例非RA患者血清中的RF、抗CCP抗体和AKA水平，并分析三种抗体在RA诊断中的价值。结果：单一抗体检测中敏感性以RF最高（82．O％），特异性以AKA最高（93．33％），阳性预测值以AKA最高（94．05％），阴性预测值以RF最高（67．47％）；联合检测中敏感性以RF＋抗CCP抗体最高（43．33％），特异性以RF＋抗CCP＋AKA最高（100％），阳性预测值以RF＋抗CCP＋AKA最高（100％），阴性预测值以RF＋抗CCP抗体最高（44．81％）。结论：RF诊断RA的灵敏性最高，但特异性以RF＋抗CCP＋AKA最高，三者联合检测可以提高对RA的诊断价值

Diagnostic Values of Combined Detection of Rheumatoid Factor,Anticyclic Citrullinated Peptide Antibody and Antikeratin Antibody in Rheumatoid Arthritis

Objective ：To evaluate the significance of the eombinatian of serum rheumatoid faetoi（ RF ）, anticycie eitrnllinated peptide antibody（ anti CCP ） and antikeratin antibody in the diagnostic value of rheumatoid arthritis （ RA ） .Method： Serum from 150 RA patients and 75 non-RA patients were analyzed.RF, anti CCP and AKA were detected using immune turhidimetry、 ELISA and indirect immunofluorescenee respectively.The distributions of these antibodies were compared to determine the diagnostic values of combined detection of RF, anti CCP and AKA in RA patients.Result： The sensitivity of single antibody detection in RF was the highest （ 82.0% ）, specificity of AKA was the highest （ 93.33% ）, the positive predictive value of AKA was the highest （ 94.05% ）, and negative predictive value of RF was the highest （ 67.47% ） ; the sensitivity of combined detection of anti CCP antibody to RF＋ in the highest （ 43.33% ）, specificity to RF＋anti CCP＋AKA was the highest （ 100% ）, the positive predictive value for RF＋anti CCP＋AKA was the highest （ 100% ）, and negative predictive value of RF＋anti CCP antibody was highest （ 44.81% ） .Conclusion： RF diagnosis of RA sensitivity is highest, but specific to RF＋anti CCP＋AKA is the highest, the three combined detection can improve the diagnostic value of the RA.