RF、抗CCP抗体、抗APF抗体、抗AKA抗体、抗MCV抗体联合检测诊断类风湿关节炎的价值

目的探讨类风湿因子（RF）、抗环瓜氨酸（CCP）抗体、抗核周因子（APF）抗体、抗角蛋白（AKA）抗体、抗突变型瓜氨酸波形蛋白（MCV）抗体联合检测诊断类风湿关节炎（RA）的价值。方法检测RA组（196例）、非RA组（157例）、健康对照组（73例）上述5种指标的阳性率、灵敏度和特异度，以及不同方案联合检测后的灵敏度和特异度。结果RF、抗CCP抗体、抗APF抗体、抗AKA抗体、抗MCV抗体灵敏度分别为76.02%、75.00%、45.92%、44.39%、72.45%，特异度分别为79.57%、96.52%、94.78%、96.09%、94.78%。RF与抗CCP抗体联合检测灵敏度为93.37%，特异度78.26%，RF、抗CCP抗体、抗APF抗体、抗AKA抗体、抗MCV抗体5个指标联合检测灵敏度为96.43%，特异度为75.65%。结论在5种指标中，RF、抗CCP抗体、抗MCV抗体灵敏度相对较高，除RF外，抗CCP抗体、抗APF抗体、抗AKA抗体、抗MCV抗体特异度均很高。5种指标联合检测后，灵敏度大大提高，特异度略有下降。

Combined detection of RF, ACCP, APF, AKA and AMCV in diagnosis of rheumatoid arthritis

Objective To assess the diagnostic value of combined detection of rheumatoid factor (RF), anti-cyclic citrullinated peptide antibodies(ACCP), anti-perinuclear factor(APF), anti-keratin antibodies (AKA) and anti-mutated citrullinated vimentin antibodies (AMCV) in rheumatoid arthritis (RA). Methods Serum levels of RF, ACCP, APF, AKA and AMCV were detected in 196 RA patients, 157 non-RA patients and 73 healthy subjects. The sensitivity and specificity of individual indicators and various combination of above indicators in diagnosis of RA were analyzed. Results The sensitivities of RF, ACCP, APF, AKA and AMCV in diagnosis of RA were 76.02%, 75.00%, 45.92%, 44.39% and 72.45%, respectively; the specificities were 79.57%, 96.52%, 94.78%, 96.09% and 94.78%, respectively. The sensitivity and specificity of combined detection of RF and ACCP were 93.37% and 78.26%. The sensitivity and specificity of combined detection of 5 indicators were 96.43% and 75.65%. Conclusion RF, ACCP and AMCV have have sensitivities, while ACCP, APF, AKA and AMCV have high specificities in diagnosis of RA. Combined detection of these five indicators can improve the sensitivity in diagnosis of RA.