抗CCP抗体和类风湿因子对类风湿关节炎诊断意义

目的研究探讨类风湿关节炎病例（以美国风湿病协会标准入选）组和对照组血清中抗CCP抗体和RF的检测,寻找合理的诊断实验方法。方法将入选病例组和对照组进行血清抗CCP抗体和RF检测,分别比较两组阳性率、两者联合检测阳性率。结果病例组与对照组RF及抗CCP抗体阳性检出率比较,具有统计学意义（χ2=16.678、χ2=112.145,P〈0.05、P〈0.05）。抗CCP抗体：灵敏度为70.25%,特异度为91.5%;RF：灵敏度为76.86%,特异度为47.06%。抗CCP抗体与RF进行联合检测时串联实验：灵敏度为61.16%,特异度为91.50%;并联实验：灵敏度为85.95%,特异度为47.06%。结论 RF和抗CCP抗体在类风湿关节炎病例组和对照组阳性率有显著差异,有利于疾病的检测诊断。两者结合起来为临床提供丰富的诊断信息,避免类风湿因子低特异性而导致误漏诊,提高了抗CCP抗体的敏感性,提高了类风湿关节炎诊断正确率。

Significance of detection of RF and anti-ccp in diagnosis of rheumatoid arthritis

Aim To analyze serological anti-CCP antibody and RF in rheumatoid arthritis patients.Methods All cases were divided into treatment group and control groups according to inclusion criteria.Anti-CCP antibody and RF in cases of both groups were determined and compared.Results The positive detection rates of RF and anti-CCP antibody in the treatment group were significantly different（χ2=16.678,P0.05 and χ2=112.145,P0.05）.The sensitivity and specificity of determination of anti-CCP antibody was 70.25 % and 91.5 %,while that of RF were 76.86 % and 47.06 %;The sensitivity and specificity of tandem determination of anti-CCP antibody and RF were 61.16% and 91.50%,while that of parallel determination were 85.95% and 47.06% respectively.Conclusion The determination of concentrations of RF and anti-CCP antibodies is useful for differential diagnosis of rheumatoid arthritis patients and non rheumatoid patients.In addition combined determination of RF and anti-CCP antibodies can improve the positive diagnostic rate and prevent from missing patients.