抗环瓜氨酸肽抗体检测在类风湿关节炎中的意义

目的 检测抗环瓜氨酸肽（CCP）抗体在类风湿关节炎（RA）中的阳性率，探讨抗CCP抗体检测在RA中的意义。方法 以根据已知cDNA序列人工合成的CCP为抗原建立ELISA方法检测294例RA，132例其他风湿性疾病，135例非风湿性疾病中的抗CCP抗体的分布。比较抗CCP抗体与抗核周因子（APF）、抗角蛋白抗体（AKA）、类风湿因子（RF）以及HLA－DR4的相关性。结果 294例RA病人中，抗CCP抗体的阳性率为46．6％，其他风湿性疾病的阳性率为5．3％，非风湿性疾病的阳性率为1．5％。抗CCP抗体对RA的敏感性和特异性分别为46．6％，96．6％。抗CCP抗体与APF、AKA以及HLA－DR4之间有相关性，与RF之间无相关性。结论 抗CCP抗体对RA具有良好的敏感性（46．6％）和特异性（96．6％），能用于RA的诊断。抗CCP抗体与AFP、AKA有相关性，但不完全重叠。抗CCP抗体可视为RA新的血清学诊断指标。

The diagnostic value of anti-cyclic citrullinated peptide antibody in patients with rheumatoid arthritis

Objective To explore the diagnostic value of anti cyclic citrullinated peptide (CCP) antibody (anti CCP) detected by ELISA in patients with rheumatoid arthritis (RA).Methods The synthesized CCP deduced from the known cDNA sequence was used as substrate in ELISA.The anti CCP was detected by ELISA in 294 RA,132 rheumatic diseases other than RA and 135 non rheumatic diseases.To compare the correlation among the anti CCP and APF (antiperinuclear factor),AKA (anti keratin antibody),RF (rheumatoid factor) and HLA DR4.Results One hundred and thirty seven (46 6%) RA sera,7 (5 3%) other rheumatic disease sera and 2 (1 8%) non rheumatic disease were found to be anti CCP positive by ELISA.The sensitivity of anti CCP was 46 6% with high specificity (96 9%) in RA.Anti CCP was associated with APF,AKA and HLA DR4 except RF.Conclusions Anti CCP presents a reasonable sensitivity (46 6%) with high specificity (96 6%) to RA and it is valuable to RA diagnosis.Anti CCP is associated with APF,AKA and HLA DR4 but not completely overlaps them.Anti CCP could be regarded as a new diagnostic marker in RA.