抗环瓜氨酸肽抗体检测对类风湿关节炎的临床诊断价值

目的探讨抗环瓜氨酸肽抗体（抗CCP抗体）检测对类风湿关节炎（RA）诊断的意义。方法采用酶联免疫吸附试验（ELISA）检测115份人血清的抗CCP抗体,同时采用免疫透射比浊法定量检测类风湿因子（RF）,包括40例RA患者,45例其它风湿病患者,30名正常人;并分析抗CCP抗体与RF实验结果之间的相关性。结果在40例RA病人中,抗CCP抗体的阳性率为80.0%,在其它风湿病人中的阳性率为7.0%,抗CCP抗体对RA的敏感性和特异性分别为80.0%、96.0%,其敏感性高于RF,但差异无统计学意义（P〉0.05）,特异性明显高于RF（P〈0.05）。联合应用抗CCP抗体与RF进行诊断,二者均阳性时敏感性为65.0%,特异性为97.3%。抗CCP抗体与RF实验结果之间无相关性。结论抗CCP抗体对RA具有较好的敏感性和很高的特异性,可与RF相互补充,联合检测可提高对RA早期诊断的准确性。

Clinical Diagnostic Value of Anti-Cyclic Citrullinated Peptide Antibody in Patients with Rheumatoid Arthritis

Objective To explore the diagnostic value of anti-cyclic citrullinated peptide antibody（anti-CCP antibody） in patients with rheumatoid arthritis（RA）.Methods Anti-CCP antibody was measured in serum from 115 subjects,including 40 RA patients,45 patients with other rheumatic diseases and 30 healthy subjects by enzymelinked immunosorbent assay（ELISA）.Rheumatoid factor（RF） was measured by immunity transmission turbidimetric assay.Correlation between anti-CCP antibody and RF was compared.Results 80.0% RA patients had anti-CCP antibody and only 7.0% of patients with other rheumatic diseases were found to be positive.The sensitivity and specificity of using anti-CCP antibody as a diagnostic value was 80.0% and 96.0% in the RA patients,respectively.Anti-CCP antibody was more specific than RF in the diagnosis（P〈0.05）.When the anti-CCP antibody and RF were applied jointly for diagnosis,the sensitivity was 65.0% and the specificity was 97.3%.The level of anti-CCP antibody was not correlated with RF.Conclusion Anti-CCP antibody has a better sensitivity and specificity for the diagnosis of rheumatoid arthritis.both anti-CCP antibody and RF can be used to increase the accuracy of early diagnosis of RA.