不明原因早期关节炎患者抗角蛋白抗体检测分析

【摘要】目的探讨抗角蛋白抗体（AKA）在早期关节炎鉴别诊断中的应用。方法选择病程小于10周的关节炎患者102例，正常对照健康人31名。用IIF法检测AKA。结果AKA阳性14例，弱阳性3例，阴性85例。经临床观察．结合X线或其他影像学结果及抗CCP抗体等血清学检查，阳性与弱阳性17例均确诊为RA；阴性85例中，8例为RA，另77例中，8例为骨关节炎，痛风性关节炎、脊柱关节病各6例，糖尿病性骨关节病和软组织风湿症各3例，格林巴利综合征1例，其余50例为未分化关节炎。正常对照组各指标均阴性。AKA对RA诊断的阳性预测值为100．0％，阴性预测值90．6％。结论测定AKA对早期类风湿关节炎与其他关节炎的鉴别有辅助意义，但有局限性。

Test and analysis of anti-keratin antibody in the early arthritis patients with unknown reasons

Objective To discuss the application of anti-keratin arthritis. Methods One hundred and two patients suffering from antibody （AKA） in the differential diagnosis of early arthritis for less than 10 weeks were included, and 31 healthy participants were selected as control group. The AKA were tested by indirect immulogicol fluorenscence meth- cals （IFF）. Results Among 102 patients, there were 14 cases with positive AKA, 3 cases with weakly positive, and 85 cases in negative. Through clinical observation, on the combination of X-ray or other imaging results and anti-CCP antibody test, all the positive and weakly positive patients were definitely diagnosed as rheumatoid arthritis （RA）. 8 out of 85 negative cases were diagnosed as RA. The rest were diagnosed as osteoarthritis （n = 8）, gouty arthritis （n = 6）, spondyloarthropathy （n = 6）, diabetic osteoarthropathy （n = 3）, rheumatism of soft tissues （n = 3）, Guillain-Barre syn- drome （n = 1）, and undifferentiated arthritis （n = 50） respectively. In the control group, the outcomes were all negative. The positive predictive value of AKA for the RA diagnosis reached 100.0%, and its negative predictive value was 90.6%. Conclusion The AKA test can identify early RA from other arthritic diseases in auxiliary, but there are still limitations.