抗CCP抗体和RF对类风湿关节炎患者诊断价值的比较

目的 评价抗环瓜氨酸肽(CCP)抗体和类风湿性关节炎因子(RF)在类风湿性关节炎(RA)中的意义. 方法 对90例RA患者、30例其他疾病患者和35例健康对照组血清用ELISA法检测抗CCP抗体、免疫散射比浊法检测RF,比较2种抗体单独或联合检测对诊断RA的敏感性、特异性、阳性预测值、阴性预测值、总符合率及Youden指数;探讨抗CCP抗体和RF的相关性,通过绘制ROC曲线,计算ROC曲线下面积(ACU). 结果 RA组抗CCP抗体和RF阳性率均高于其他疾病患者和健康对照组(P<0.0125);RF诊断RA的敏感性高于抗CCP抗体;抗CCP抗体对论断RA的其他5项指标均高于RF;抗CCP抗体和RA联合检测对RA的诊断的敏感性明显高于抗CCP抗体、RF两项检测指标;另外,抗CCP抗体和RA联合检测对RA的诊断的阴性预测值,总符合率及Youden指数也高于抗CCP抗体、RF两项检测指标.抗CCP抗体、RF及两者联合检测ROC曲线下面积(ACU)均>0.5,并且抗CCP抗体与RF联合检测AUC大于抗CCP抗体及RF的AUC. 结论 抗CCP抗体对RA有较高的诊断价值.和RF联合检测对诊断RA有重要意义.

Comparation of the Diagnostic Value of Anti-Cyclic Citrullinated Peptide Antibody and Rheumatoid Factor in Patients with Rheumatoid Arthritis

AbstractObjectiveTo evaluate the role of anti-cyclic citrullinated peptide antibody(ACCP) and rheumatoid factor(RF) in patients with rheumatoid arthritis. MethodsACCP antibody and RF were detected in serum samples of 90 RA patients, 30 other diseases patients and 35 healthy blood donors.The sensitivity,specificity,positive predictive value, negative predictive value, agreement rate and Youden`s index of these parsmeters for the diangnosis of RA were analyzed. We maped the receiver operative characteristic curve (ROC) and calculated area under the ROC curve .ResultsThe positive rates of ACCP and RF were higher than those of patients with other diseases or healthy controls(P<0.0125). The sensitivity of RF (61.1%) showed difference from ACCP(63.3%); but the other 5 parameters of ACCP was significantly higher than RF. Combining ACCP with RF, the sensitivity was significant different from one diagnostic indicator. Both the three diangnostic indicators had large areas under the ROC curve(P>0.5). ConclusionACCP is a valuable index for RA diagnosis. It is useful in improving the diagnostic accuracy of RA.