RF、AKA和抗CCP抗体联检对类风湿关节炎诊断的临床价值

目的:探讨类风湿因子(Rheum atoid factor,RF)、抗角质蛋白抗体(antikeratin antibody,AKA)及抗环瓜氨酸肽(anti-cyc lic c itru llinated peptide,CCP)抗体对类风湿关节炎(rheum atoid arthritis,RA)的临床意义和早期应用价值。方法:对40例类风湿关节炎患者、30例系统性红斑狼疮和30名正常健康体检者进行RF、AKA、抗CCP抗体检测,应用速率散射比浊法测定RF,间接免疫荧光法检测AKA,ELISA法测定抗CCP抗体。结果:40例RA患者血清中,RF灵敏度和特异性分别为70.0%、90.0%,AKA灵敏度和特异性分别为35.0%、96.7%,抗CCP抗体灵敏度和特异性分别为85.0%、93.3%,联检RF、AKA及抗CCP抗体灵敏度和特异性分别为97.07%、99.8%。结论:RF、AKA和抗CCP抗体可作为诊断RA比较特异的血清学指标,三项指标联检可在一定程度上弥补RF对RA的诊断不足,提高RA的阳性诊断率,且有助于疾病的预后判断。

Clinical Diagnostic Value of Combined Determination of Serum RF,AKA and Anti- CCP Antibody Levels in Patients with Rheumatoid Arthritis

Objective To investigate the clinical usefulness of combined determination of serum rheumatic factor(RF),anti-karatin antibody(AKA) and anti-cyclic citrullinated peptide antibody(anti-CCP antibody) levels for early diagnosis in patients with rheumatoid arthritis(RA).Methods Serum RF(with rate-nephelometry),AKA(with indirect immuno-fluorescence) and anti-CCP antibody(with ELISA) levels were determined in 40 patients with RA,30 patients with SLE and 30 controls.Results For diagnosis of RA,the sensitivity and specificity of RF was 70.0% and 90.0% respectively,the sensitivity and specificity of AKA was 35.0% and 96.7%, the sensitivity and specificity of anti-CCP-antibody was 85% and 93.3% respectively.With combined determination of RF,AKA and anti-CCP antibody,the sensitivity and specificity would be the highest,being 97.07 and 99.8% respectively.Conclusion RF,AKA and anti-CCP antibody were useful diagnostic serum markers for rheumatoid arthritis and combined determination of these markers would be very leliful for early diagnosis.