抗突变型瓜氨酸波形蛋白抗体在类风湿关节炎中的诊断价值

Objective To assess the diagnostic value of anti-mutated citrullinated vimentin antibodies (anti-MCV) for rheumatoid arthritis (RA), and compare it with anti-cyclic citrullinated peptide antibodies (anti-CCP), rheumatoid factors (RF). Methods Commercially available enzyme-linked immunosorbent assay (ELISA) kit was used to detect anti-MCV antibodies in a group of 177 RA patients, 46 patients with other rheumatic diseases, and 48 healthy blood donors. At the same time, anti-CCP, RF were detected. T test and χ2 test were selected. Results The average concentration of anti-MCV was (523±376) U/ml in RA, (96± 55) U/ml in patients with other rheumatic diseases, (34±18) U/ml in healthy controls. Different threshold levels (20, 40, 60, 80, 100, 120, 140 U/ml) for positive results were calculated bythe areas under the ROC curve (the areas were 0.521, 0.706, 0.769, 0.791, 0.816, 0.826, 0.822), then the best diagnosis efficacy for RA was determined as more than 120 U/ml. At this level, the sensitivity and the specificity for anti-MCV were 80.1% and 80.9% for RA diagnosis. The positive and negative predictive value were 92% and 67.8%. Comparing with anti-CCP, anti-MCV showed comparable specificity but higher sensitivity. And it's also better than RF apparently. If all 3 antibodies were detected at the same time, or anti-MCV combine with one of them, the sensitivity would increase to 95.7%. In addition, Anti-MCV showed positive in 32 of 67(55.2%) patients with RA whose anti-CCP was negative, meanwhile 31 of 59 (52.5%) patients with RA whose RF was negative. Conclusion RF and anti-CCP are complementary in diagnosing RA. The combination detection of RF and anti-CCP could significantly improve the specificity for the diagnosis of RA.     

抗突变型瓜氨酸波形蛋白抗体在类风湿关节炎中的诊断价值

Objective To assess the diagnostic value of anti-mutated citrullinated vimentin antibodies (anti-MCV) for rheumatoid arthritis (RA), and compare it with anti-cyclic citrullinated peptide antibodies (anti-CCP), rheumatoid factors (RF). Methods Commercially available enzyme-linked immunosorbent assay (ELISA) kit was used to detect anti-MCV antibodies in a group of 177 RA patients, 46 patients with other rheumatic diseases, and 48 healthy blood donors. At the same time, anti-CCP, RF were detected. T test and χ2 test were selected. Results The average concentration of anti-MCV was (523±376) U/ml in RA, (96± 55) U/ml in patients with other rheumatic diseases, (34±18) U/ml in healthy controls. Different threshold levels (20, 40, 60, 80, 100, 120, 140 U/ml) for positive results were calculated bythe areas under the ROC curve (the areas were 0.521, 0.706, 0.769, 0.791, 0.816, 0.826, 0.822), then the best diagnosis efficacy for RA was determined as more than 120 U/ml. At this level, the sensitivity and the specificity for anti-MCV were 80.1% and 80.9% for RA diagnosis. The positive and negative predictive value were 92% and 67.8%. Comparing with anti-CCP, anti-MCV showed comparable specificity but higher sensitivity. And it's also better than RF apparently. If all 3 antibodies were detected at the same time, or anti-MCV combine with one of them, the sensitivity would increase to 95.7%. In addition, Anti-MCV showed positive in 32 of 67(55.2%) patients with RA whose anti-CCP was negative, meanwhile 31 of 59 (52.5%) patients with RA whose RF was negative. Conclusion RF and anti-CCP are complementary in diagnosing RA. The combination detection of RF and anti-CCP could significantly improve the specificity for the diagnosis of RA.     

抗突变型瓜氨酸化波形蛋白抗体检测在类风湿关节炎中的意义

目的 评价抗突变型瓜氨酸化波形蛋白（MCV）抗体在类风湿关节炎（RA）诊断中的价值。方法 检测136例RA患者，80例其他结缔组织病患者以及19名正常对照血清中抗MCV抗体的分布，比较抗MCV抗体与类风湿因子（RF）、抗环瓜氨酸肽（CCP）抗体和抗角蛋白抗体（AKA）的相关性，并分析上述抗体在RA诊断中的意义。结果 136例RA患者抗MCV抗体敏感性和特异性分别为95．6％和80．8％．与非RA对照组比较差异有统计学意义（P〈0．05）。抗MCV抗体与抗CCP抗体、AKA和RF的重叠阳性率分别为91．9％、52．8％和76．5％。经统计学分析，抗MCV抗体与抗CCP抗体、AKA和RF之间存在相关性。结论 抗MCV抗体对RA有较高的诊断价值，可视为RA新的血清学诊断指标．能提高RA的早期诊断率。     

抗突变型瓜氨酸波形蛋白抗体在类风湿关节炎诊断中的意义

目的了解抗突变型瓜氨酸波形蛋白(MCV)抗体在类风湿关节炎(RA)诊断中的意义,并比较抗MCV抗体与类风湿因子(RF)、抗核周因子(APF)、抗角蛋白抗体(AKA)、抗环瓜氨酸多肽(CCP)抗体以及某些临床指标的相关性。方法对166例研究对象,包括74例RA患者(其中早期18例,中晚期56例),50例非RA的风湿性疾病患者,42名健康对照,应用酶联免疫吸附试验(ELISA)检测血清中的抗MCV抗体,同时检测其他相关自身抗体,结合临床资料进行分析。结果74例RA中抗MCV抗体阳性58例,对RA诊断的敏感性为78％,特异性为95％,阳性预测值和阴性预测值分别为97％和71％。抗MCV抗体阳性的平均抗体浓度依次为(552±380)U/ml(RA组),(162±63)U/ml(非RA组),(63±46)U/ml (健康对照组)。RA组的平均抗体水平较高。抗MCV抗体和抗CCP抗体相关性最强(r=0．502,P=0．000),APF、AKA次之(r=0．369、0．408,P＜0．01)。抗MCV抗体与各项临床、实验室指标间的差异无统计学意义(P＞0．05)。结论抗MCV抗体在RA中具有较高的敏感性和特异性,且较APE、AKA与抗CCP抗体相关性强,可作为RA诊断的辅助指标。抗MCV抗体可能与病情活动度、功能状态无关。     

血清抗突变型瓜氨酸波形蛋白抗体在类风湿关节炎诊断中的价值

目的探讨抗突变型瓜氨酸波形蛋白(MCV)抗体在类风湿关节炎(RA)诊断中的价值。方法采用ELISA法测定68例RA患者(RA组)、62例关节疼痛及自身免疫性疾病患者(疾病对照组)、129例健康体检者(正常对照组)的抗MCV抗体、抗环瓜氨酸肽(CCP)抗体水平,计算抗MCV抗体与抗CCP抗体诊断RA的敏感性与特异性;速率散射比浊法检测CRP水平,记录压痛关节数(TJC)、肿胀关节数(SJC),并计算DAS28积分值。对抗MCV抗体与抗CCP抗体及DAS28积分(包括CRP、TJC、SJC三个变量)进行Spearman秩相关性分析。结果 RA组抗MCV抗体、抗CCP抗体、DAS28积分值显著高于疾病对照组及正常对照组;抗MCV抗体与抗CCP抗体诊断RA的敏感性分别为88.2%(60/68)、75.0%(51/68),P=0.026;特异性分别为97.3%(186/191)、95.8%(183/191),P=0.548。抗MCV与抗CCP抗体呈显著正相关(r=0.826,P<0.05);抗MCV与RA活动度指标DAS28积分及CRP、肿胀关节数间均有明显相关性。结论抗MCV抗体在RA诊断中较抗CCP抗体具有更高的敏感性和特异性,能为RA诊断提供良好的依据,且抗MCV抗体与RA病情活动度指标相关,高滴度的抗MCV可能在一定程度上提示RA的病情活动。     

抗突变型瓜氨酸波形蛋白抗体对类风湿关节炎患者一年关节影像学进展的预测价值

目的:探讨抗突变型瓜氨酸波形蛋白（MCV）抗体对类风湿关节炎（RA）患者1年关节影像学进展的预测价值。方法:选2014年11月至2018年7月中山大学孙逸仙纪念医院风湿免疫科门诊和住院的RA患者,收集患者的临床资料,包括基于C反应蛋白的28个关节疾病活动度评分（DAS28-CRP）等。检测患者抗MCV抗体等。随访1年,...     

抗突变型瓜氨酸波形蛋白抗体葡萄糖-6-磷酸异构酶和抗环瓜氨酸多肽抗体检测在类风湿关节炎诊断中的价值

目的 了解抗突变型瓜氨酸波形蛋白(MCV)抗体、葡萄糖-6-磷酸异构酶(GPI)、抗环瓜氨酸多肽(CCP)抗体检测在类风湿关节炎(RA)诊断中的价值.方法 检测109例RA患者,24例其他风湿病患者及19名健康对照血清中抗MCV抗体、GPI和抗CCP抗体,比较3种抗体单独或联合检测对诊断RA的敏感性和特异性.结果 RA组抗MCV抗体和GPI阳性率及平均浓度显著高于其他风湿病组及健康对照组(P<0.05).抗CCP抗体与GPI阳性率在RA患者中的差异有统计学意义.抗MCV抗体对RA敏感性最高(99.1%);抗CCP抗体对RA特异性最高(90.7%);联合检测以MCV+CCP、MCV+GPI以及MCV+CCP+GPI特异件最高(均为98.1%).结论 单独或联合检测抗MCV抗体、抗CCP抗体和GPI,有助于提高RA诊断的敏感性和特异性.     

63例类风湿关节炎患者抗MCV抗体检测及分析

目的探讨抗突变型瓜氨酸波形蛋白(MCV)抗体检测在类风湿关节炎(RA)诊断中的临床意义。方法选择RA患者(RA组)、其他自身免疫病患者(AD组)、健康查体者(对照组)各63例,均采用ELISA法定量检测抗MCV抗体和抗环瓜氨酸肽(CCP)抗体,用速率散射免疫比浊法检测类风湿因子(RF)-IgM,用四格表计算抗MCV抗体、抗CCP抗体和RF-IgM诊断RA的敏感性、特异性、阳性预测值及阴性预测值。结果 RA组抗MCV抗体、抗CCP抗体与RF-IgM阳性率均显著高于AD组和对照组(P均<0.01);抗MCV抗体的诊断敏感性和特异性均显著高于RF-IgM(P均<0.05),其中敏感性显著高于抗CCP抗体(P<0.05);抗MCV抗体诊断RA的阳性预测值和阴性预测值均略高于抗CCP抗体及RF-IgM(P均>0.05)。结论抗MCV抗体对RA有较高的诊断价值,且检测方法简便、快捷,可作为筛查和辅助诊断RA的重要指标。     

抗环瓜氨酸多肽抗体在类风湿关节炎诊断中的价值

目的 了解抗环瓜氨酸多肽(CCP)抗体在中国人群中诊断类风湿关节炎的敏感度、特异度及其对类风湿关节炎发病的预测价值.方法 收集2007年11月至2008年3月在上海长征医院进行健康体检的健康人群1018例,风湿科门诊及住院确诊类风湿关节炎患者212例,其他结缔组织病患者435例,应用酶联免疫吸附法检测其血清抗CCP抗体滴度,对健康人群及类风湿关节炎患者同时检测IgM型类风湿因子(IgM-RF).比较抗CCP抗体阳性率及滴度差异,并统计健康人群和类风湿关节炎患者中IgM-RF的阳性率,计算IgM-RF诊断类风湿关节炎的特异度.结果 (1)类风湿关节炎患者血清抗CCP抗体阳性率为48.1%(102例),明显高于健康人群(2.6%,26例)和其他结缔组织病患者(3.7%,16例),其诊断类风湿关节炎的特异度高达97.4%.(2)类风湿关节炎患者抗CCP抗体滴度为429.7 U,明显高于健康人群(29.3 U)和其他结缔组织病患者(36.5 U).(3)IgM-RF在类风湿关节炎患者中的阳性率为94.3%,而在健康人群中的阳性率为21.5%.抗CCP抗体的假阳性率(2%)显著低于IgM-RF(21.5%,P＜0.01).结论 抗CCP抗体在类风湿关节炎诊断中具有高度的特异度,且类风湿关节炎患者血清中抗CCP抗体滴度明显高于健康人群及其他结缔组织病患者.抗CCP抗体阳性对类风湿关节炎的诊断更具有价值.

Abstract：

Objective To determine the sensitivity and specificity of anti-cyclic citrullinated peptide antibodies (anti-CCP antibodies) in the diagnosis of rheumatoid arthritis. Method A total of 1018healthy donors, 212 patients with rheumatoid arthritis, 435 patients with other connective tissue disease were recruited to this study. Anti-CCP antibodies and IgM-rheumatoid factor (RF) were determined by ELISA according to manufacturer instructions, with a cut-off of 20U. Result The frequency of positive anti-CCP antibodies in patients with rheumatoid arthritis is 48.1% (n = 102 ), higher than healthy donors (2.6%,n = 26) and patients with other connective tissue diseases (3.7%, n = 16). The specificity of anti-CCP antibodies is 97.4%. The titer of anti-CCP antibodies in patients with rheumatoid arthritis (429. 7 U) is much higher than that in healthy donors (29. 3 U ) and patients with other connective tissue diseases (36. 5 U). The frequency of positive IgM-RF in patients with rheumatoid arthritis is 94. 3% whilst only21.5% in healthy donors. The false positivity rate of IgM-RF is higher than anti-CCP antibody. Conclusion Anti-CCP antibodies is a highly specific autoantibody in the diagnosis of rheumatoid arthritis.     

血清抗角蛋白抗体抗环瓜氨酸肽抗体和类风湿因子在类风湿关节炎中的意义

目的 评价抗角蛋白抗体(AKA)、抗环瓜氨酸肽(CCP)抗体和类风湿因子(RF)在类风湿关节炎(RA)中的意义.方法 收集82例RA患者及56例非RA患者,测定其抗CCP抗体、AKA和RF水平,评价对RA诊断的敏感性、特异性,比较RA患者中抗CCP抗体、AKA阳性组和阴性组的压痛关节数、肿胀关节数、红细胞沉降率(ESR)、C反应蛋白(CRP)、疾病活动指数(DAS)、Ritchie's指数(RAI).结果 单独检测AKA、抗CCP抗体、RF及联合检测的曲线下面积都较高(P<0.05).抗CCP抗体、AKA的特异度分别为92.9%、91.1%,联合检测AKA、抗CCP抗体和RF有任何一种及以上阳性的灵敏度最高,为95.1%.抗CCP抗体阳性组与阴性组的关节肿胀数、关节压痛数、ESR、CRP、DAS、RAI差异有统计学意义(P<0.05);AKA阳性组与阴性组的关节肿胀数、ESR、DSA差异均有统计学意义(P<0.05).结论 联合检测抗CCP抗体、RF、AKA对诊断RA有意义,抗CCP抗体、AKA可能与RA的活动度相关.     

Value of anti-mutated citrullinated vimentin antibodies in diagnosing rheumatoid arthritis

We assessed the diagnostic value of anti-mutated citrullinated vimentin antibodies (anti-MCV) and compared it with those of anti-cyclic citrullinated peptide antibodies (anti-CCP), IgA (ARF), IgM (MRF) and IgG (GRF) rheumatoid factors for rheumatoid arthritis (RA). Serum samples of 170 RA patients, with early and established RA, and 309 controls were tested for anti-MCV, anti-CCP, ARF, MRF and GRF using commercially available ELISA kits. Cut off of different tests was determined with ROC curves. The sensitivity and the specificity of anti-MCV were 74.1 and 79%, respectively. Sixty-five of 309 (21%) controls were anti-MCV positive. Sensitivity and specificity of anti-CCP were 72.4 and 96.1%, respectively. Only 12 of 309 (3.9%) controls were anti-CCP positive. Sensitivity of ARF, MRF and GRF were 64.1, 65.9 and 68.2%, respectively. Their specificity was 79.6, 74.4 and 68.9%, respectively. No significant association was observed between the antibodies tested and extrarticular manifestations. Anti-MCV shows comparable sensitivity but lower specificity than that of anti-CCP. They do not appear to be very useful in the diagnosis of RA.     

Role of anti-mutated citrullinated vimentin antibodies in chronic hepatitis C patients and its relation to HCV associated arthritis

Aim of the work

To determine the frequency of anti-mutated citrullinated vimentin (anti-MCV) antibodies in chronic hepatitis C virus (HCV) patients and its relation to HCV associated arthritis.

抗环瓜氨酸肽抗体类风湿因子与类风湿关节炎活动度及骨侵蚀相关性的研究

目的探讨抗环瓜氨酸肽抗体（ACCP）及类风湿因子（RF）各亚型与类风湿关节炎（RA）疾病活动度及骨质侵蚀的相关性.方法收集110例RA患者,用SPSS10.0软件比较ACCP、RF（IgA、IgM、IgG）与病情活动指数（disease activity score,DAS）、Ritchie′s指数（Ritchie′s articular index,RAI）的相关性,以判断ACCP、RF（IgA、IgM、IgG）与疾病活动度的关系.将病程＞2年的病例分为骨质侵蚀组和非骨质侵蚀组,比较两组之间ACCP、RF（IgA、IgM、IgG）的差异.结果经Spearman相关分析,IgM-RF与RAI呈正相关,ACCP及RF其他亚型与DAS、RAI未显示明显相关性.ACCP、RF各亚型与骨质侵蚀均未表现明显相关性.结论IgM-RF与疾病活动度相关,ACCP及RF各亚型与骨质侵蚀未表现出相关性.