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六种自身免疫性抗体联合检测在早期类风湿关节炎诊断中的临床意义
引用本文:胡喜梅,樊志荣,包维莺,周水阳,韦薇,柯金,范燕琴,陆翠,刘媛,戴永援,王恒石,朱锐锋,曹云芳,张红. 六种自身免疫性抗体联合检测在早期类风湿关节炎诊断中的临床意义[J]. 中国医药导报, 2011, 8(30): 45-47
作者姓名:胡喜梅  樊志荣  包维莺  周水阳  韦薇  柯金  范燕琴  陆翠  刘媛  戴永援  王恒石  朱锐锋  曹云芳  张红
作者单位:1. 上海市松江区中心医院风湿科,上海,201600
2. 上海市松江区中心医院儿科,上海,201600
3. 上海市松江区中心医院检验科,上海,201600
摘    要:目的:研究类风湿因子(RF)、隐性类风湿因子(HRF)(RFIgA、RFIgG、RFIgM),抗角蛋白抗体(AKA),抗环瓜氨酸肽抗体(抗CCP抗体)的联合检测对类风湿关节炎(RA)的早期诊断价值。方法:采用比浊法检测RF,采用ELISA法定量检测HRF,采用ELISA法检测抗CCP抗体,间接免疫荧光法检测AKA。回顾性分析了RA患者301例,其中3、12、24个月以内的早期RA患者分别为62、142和171例;非RA的风湿病患者125例。通过病程分期把RA分成早期(病程24个月之内)和中晚期患者(病程24个月以上),比较早期RA各因子之间的敏感性、特异性及联合检测的结果。结果:病程≤3个月分别与病程≤12个月、≤24个月各项诊断指标敏感性比较,差异无统计学意义(P〉0.05)。特异性由高到低依次为AKA(97.37%)、抗CCP(92.24%)、RFIgG(90.76%)、RFIgM(82.20%)、RFIgA(77.31%)、RF(76.71%)。联合检测,RF(-)的RA患者,AKA阳性率达22.50%(9/40),抗CCP抗体阳性率达57.58%(19/33),HRF阳性率达55.00%(22/40),其他5项中1项以上阳性率达50.00%(9/18);RF(+)者其他5项中1项以上阳性率达89.74%(70/78);RF(-)抗CCP抗体(-)者其他4项中1项以上阳性率达23.81%(5/21)。结论:6种自身抗体均可出现在早期的RA患者,联合检测对RA早期诊断有较高的价值,其中AKA、抗CCP抗体对RA有高度的特异性,且在RA早期即可出现。

关 键 词:自身免疫性抗体  类风湿因子  类风湿关节炎  诊断

The significance of six self-immunity antibodies assay in early diagnosis of rheumatoid arthritis
HU Ximei,FAN Zhirong,BAO Weiying,ZHOU Shuiyang,WEI Wei,KE Jin,FAN Yanqin,LU Cui,LIU Yuan,DAI Yongyuan,WANG Hengshi,ZHU Ruifeng,CAO Yunfang,ZHANG Hong. The significance of six self-immunity antibodies assay in early diagnosis of rheumatoid arthritis[J]. China Medical Herald, 2011, 8(30): 45-47
Authors:HU Ximei  FAN Zhirong  BAO Weiying  ZHOU Shuiyang  WEI Wei  KE Jin  FAN Yanqin  LU Cui  LIU Yuan  DAI Yongyuan  WANG Hengshi  ZHU Ruifeng  CAO Yunfang  ZHANG Hong
Affiliation:HU Ximei1,FAN Zhirong2,BAO Weiying1,ZHOU Shuiyang1,WEI Wei3,KE Jin1,FAN Yanqin1,LU Cui1,LIU Yuan1,DAI Yongyuan1,WANG Hengshi1,ZHU Ruifeng1,CAO Yunfang3,ZHANG Hong1 1.Department of Rheumatology,the Center Hospital of Songjiang District,Shanghai 201600,China,2.Department of Pediatrics,3.Department of Laboratory
Abstract:Objective:To investigate the clinical effect of combined detection of rheumatoid factor(RF),hidden rheumatoid factor(HRF)(including RFIgA,RFIgG,RFIgM),anti-keratin antibody(AKA),anti-cyclic citrullinated peptide(CCP) antibody in the early diagnosis of rheumatoid arthritis(RA).Methods:RF was determined by turbidimetric assay,HRF and anti-CCP antibody were determined by ELISA,AKA were determined by indirect immunofluorescence.426 samples were selected by the study.Within the samples,301 were RA patients(withi...
Keywords:Self-immunity antibody  Rheumatoid factors  Rheumatoid arthritis  Diagnosis  
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