抗环瓜氨酸肽抗体对类风湿性关节炎诊断的应用价值

目的研究抗环瓜氨酸肽(抗-CCP)抗体在类风湿性关节炎(RA)中的临床应用价值。方法将50例RA、20例其他风湿性疾病患者和20名健康人,用酶联免疫吸附试验(ELISA)进行抗-CCP抗体检测,同时乳胶凝集法测定类风湿因子RF(IgM)]。结果抗-CCP抗体对RA诊断的灵敏度为84%,特异性为97.50%,阳性和阴性预测值分别为97.67%和82.98%,阳性和阴性似然比分别为33.60和0.16。抗-CCP抗体诊断的准确性为90%,RF为75.6%,差异具有统计学意义(u=2.56,P<0.01),两指标间的符合率为78%。当两者联合检测时可使特异性达到近100%。结论抗-CCP抗体对RA的诊断具有良好的灵敏度和特异性,比IgM RF更具特异性,两者联合检测时可极大地提高特异性。

Clinical Value of Anti-Cyclic Citrullinated peptide Antibody in the Diagnosis of Rheumatoid Arthritis

Objective]To study the clinical value of anti-cyclic citrullinated peptide(anti-CCP) antibody in the diagnosis of rheumatoid arthritis.Methods]Serum samples 50 RA patients,20 patients with other rheumatic diseases and 20 healthy people were collected;ELISA was applied to detect the CCP antibody;latex agglutination method was used to determine RF(IgM).Results]The diagnostic sensitivity of anti-CCP was 84.00% with specificity of 97.50% in RA;positive and negative predictive values were 97.67% and 82.98% respectively while positive and negative likelihood ratios were 33.60 and 0.16 respectively,the difference was significant(P<0.01);when the two antibodies were used together,specificity reached to nearly 100%.Conclusion]Anti-CCP antibody has an excellent testing sensitivity and specificity in diagnosing rheumatoid arthritis,even more specific than IgM RF;the specificity can be greatly improved by combining the two detection methods.