四项指标联合检测在类风湿关节炎诊断中的应用

目的探讨抗环瓜氨酸肽抗体（anti-CCP）、葡萄糖-6-磷酸-异构酶抗原（GPI）、抗角蛋白抗体（AKA）、类风湿因子（RF），四项指标联合检测在类风湿关节炎fRA）诊断中的价值。方法对78例RA、86例非RA其他风湿病患者、80名健康志愿者的anti-CCP、GPI、AKA、RF进行检测。结果78例RA患者中anti-CCP、GPI、AKA及RF的灵敏度分别为51.2％（40／78）、42.3％（33／78）、29.5％（23／78）和58.9％（46／78）；特异性分别为98.2％（163／166）、98.8％（164／166）、98.2％（163／166）和81.9％（136／166）。86例非RA其他风湿病患者anti-CCP、GPI、AKA及RF的阳性率分别为2.33％（2／86）、2.33％（2／86）、3.49％（3／86）和33.7％（29／86）；80名正常对照组中检测到1例抗CCP弱阳性，1例RF阳性，其余指标均为阴性。结论anti-CCP、GPI、AKA对RA诊断灵敏度不高，但均是RA的特异性诊断指标，三者与RF可相互补充，适当的联合检测有助于提高诊断的特异性。

Application of joint detection of four serum indicators in diagnosis of rheumatoid arthritis

Objective To evaluate the clinical value of combined detection of anti-cyclic citrullinated peptide antibody ,glucose-6-phosphate isomerase,anti-keratin antibody and rheumatoid factor for early diagnosis of rheumatoid arthritis. Methods The levels of anti-CCP,GPLAKA,RF in 78 patients with established RA,86 patients with other rheumatic diseases and 80 normal controls were determined. Results The sensitivity of anti-CCP,GPI,AKA and RF in the diagnosing of RA were 51.2%（40/78）, 42.3%（33/78）, 29.5%（23/78） and 58.9% （46/78）,respectively;the specificity were 98.2% （163/166）, 98.8%（164/166）, 98.2%（163/166） and 81.9% （136/166）,respectively.The positive rates of anti-CCP,GPI, AKA and RF in other rheumatic diseases patients were 2.33%（2/86）, 2.33%（2/86）, 3.49%（3/86） and 33.7%（29/86）.There was one faintly positive result of anti-CCP and one positive result of RF in 80 normal controls. Conclusion Though the sensitivity of anti-CCP, GPI, AKA are not high in diagnosis of RA but they are still thespecific indicators and combined detection of these indicators can enhance the specificity in diagtnosis of RA.