RF、CRP和抗CCP抗体联合检测对类风湿关节炎的诊断意义

目的：通过分析类风湿关节炎的临床资料及进行类风湿因子（RF）、C反应蛋白（CRF）及抗环瓜氨酸肽抗体（抗CCP抗体）的检查，探讨RF、CRP及抗CCP抗体联合检测在诊断类风湿关节炎患者的临床应用价值。方法对本院的115例类风湿关节炎的患者及131例非类风湿性患者的血清，用酶联免疫吸附试验检测抗CCP抗体、免疫比浊法对RF、CRP进行定量检测，然后对RF、CRP及抗CCP抗体检查结果进行分析。结果类风湿关节炎组RF、CRP及抗CCP抗体检测的阳性率显著高于非类风湿关节炎组，抗CCP抗体对类风湿关节炎的敏感性为64.5%， CRP对类风湿关节炎的敏感性为69.9%， RF对类风湿关节炎的敏感性为60.5%，略低于抗CCP抗体和CRP；RF对类风湿关节炎的特异性为79.3%，抗CCP抗体的特异性最高94.0%， CRP较低为55%；抗CCP抗体和RF、CRP联合检测时对RA诊断的敏感性为73.5%，特异性为98.9%。经统计学检验， RF、CRP及抗CCP抗体联合检测的灵敏性与单独应用时差异无统计学意义；RF、CRP及抗CCP抗体联合检测特异性比抗CCP抗体、RF、CRP高，差异有统计学意义。结论临床单独将RF、CRP或抗CCP抗体的检查用于类风湿关节炎的诊断敏感性和特异性一般，为提高类风湿关节炎诊断的敏感性和特异性，应该将RF、CRP和抗CCP抗体检测进行联合应用。

Diagnostic value of RF,CRP and anti-CCP antibody for combined detection of rheumatoid arthritis

Objective To analyze the clinical data of rheumatoid arthritis and conduct RF, CPR and anti-CCP antibodies checks, and explore the clinical value of RF, CPR and anti-CCP antibodies in the diagnosis of patients with rheumatoid arthritis. Methods 115 cases of our hospital patients with rheumatoid arthritis and 131 cases of non-rheumatoid patient＆#39;s serum by enzyme-linked immunosorbent assay detection of anti-CCP antibodies , immune turbidimetric method for RF, CPR for quantitative detection , and then RF, CPR and anti-CCP antibody test results were analyzed . Results Rheumatoid arthritis group RF, CPR and anti-CCP antibody positive rate was significantly higher than non-rheumatoid arthritis group , anti-CCP antibodies in rheumatoid arthritis with a sensitivity of 64.5%, CRP rheumatoid arthritis sensitivity was 69.9%, RF sensitivity of rheumatoid arthritis was 60.5%, slightly lower anti-CCP antibodies and CRP;RF rheumatoid arthritis specificity of 79.3%, specificity of anti-CCP antibodies highest 94.0%, CRP was 55%lower;anti-CCP and RF, CRP combined detection sensitivity for the diagnosis of RA was 73.5%, specificity of 98.9%. Comparing RF, CPR and anti-CCP antibody combined with RF, CPR and anti-CCP lone, there was no significant difference in the detection sensitivity .But the specificity is higher, and there are significant difference. Conclusion If we separated the clinical of RF, CRP or anti-CCP antibodies in rheumatoid arthritis check the diagnostic sensitivity and specificity is general.To improve the diagnosis of rheumatoid arthritis, sensitivity and specificity, we should conduct the combine of RF, CRP and anti-CCP antibody detection into applications.