抗环瓜氨酸肽抗体检测在类风湿关节炎诊断中的临床意义

目的 检测类风湿关节炎(RA)血清中的抗环瓜氨酸肽(抗-CCP)抗体对RA诊断的灵敏度和特异性及其在风湿性疾病中的临床应用价值。方法 用酶联免疫吸附试验(ELISA)对175例RA、其他风湿性疾病患者133例和健康人41名进行抗-CCP抗体检测，并分析RA其他诊断指标与抗-CCP抗体的相关性。结果 175例RA患者中，抗-CCP抗体阳性率为84．6％(148／175)，其他风湿性疾病的阳性率为5．3％(7／133)。抗-CCP抗体对RA诊断的灵敏度为84．6％，特异性为94．7％。阳性和阴性似然比分别为16．08和0．16。抗-CCP抗体和类风湿因子(RF)、抗核周因子(APF)、抗角蛋白抗体(AKA)具有相关性。结论 抗-CCP抗体对RA诊断具有良好的灵敏度和特异性，可视为RA新的血清学指标。

Determination of anti-cyclic citrullinated peptide antibody in patients with rheumatoid arthritis and its clinical application

Objective To evaluate the diagnostic sensitivity and specificity of the assay of anti-cyclic citrullinated peptide antibody (anti-CCP) in serum of patients with rheumatoid arthritis(RA), the diagnostic value in Rheumatic Disease and the correlation among anti-CCP, anti-pernuclear factor (APF), anti-keratin antibody (AKA) and Rheumatoid Factor (RF). Methods 175 serum samples of patients with Rheumatoid Arthritis, 133 serum samples of other rheumatic diseases and 41 serum samples of healthy were tested for anti-CCP by ELISA. Results 148 (148/175, 84 6%) RA sera and 7 (7/133, 5 3%) other rheumatic diseases sera were found to be anti-CCP positive. The diagnostic sensitivity of anti-CCP was 84 6% with a specificity of 94 7% in RA. Positive and negative likelihood ratios were 16 08 and 0 16 respectively. Anti-CCP was associated with APF, AKA and RF. Conclusion Anti-CCP presents good specificity and diagnostic sensitivity in rheumatoid arthritis. Anti-CCP could be regarded as a new diagnostic marker in RA.