联合检测ICTP和抗CCP抗体对类风湿关节炎早期诊断的意义

摘要:目的　探讨联合检测血清I型胶原吡啶交联终肽（ICTP）和抗环瓜氨酸肽抗体（ACCP）对类风湿关节炎（RA）早期诊断的意义。方法　检测并比较RA组150例患者（早期RA组62例）、非RA组和健康对照组各100例观察对象的ICTP、ACCP、类风湿因子（RF）。运用受试者工作特征（ROC）曲线及曲线下面积（AUC）评价3项指标单独及联合检测对早期RA的诊断价值。结果　ICTP、ACCP、RF在早期RA的诊断中的最佳临界值分别为4.15 μg/L、27.8 U/L、21.5 IU/ml，灵敏度分别为75.8%、74.2%、69.4%，特异度分别为84.0%、94.0%、68.0%。ICTP和ACCP联合检测诊断早期RA的AUC为0.964，灵敏度和特异度分别为85.5%、95.0%。早期RA组ICTP、ACCP水平明显高于非RA组和健康对照组，P＜0.01；RA组ICTP和ACCP的阳性率与病程长短差异无统计学意义，P＞0.05。结论　联合检测ICTP和ACCP能提高RA早期诊断的灵敏度和特异度，可作为RA早期诊断的理想血清学指标。

Clinical value of combined detection of pyridinoline cross-linked carboxy terminal telopeptide of type I collagen and anti-cyclic citrullinated peptide antibody in patients with early rheumatoid arthritis

Abstract: Objective The aim of this study was to investigate the clinical value of combined detection of serum pyridinoline cross-linked carboxy terminal telopeptide of Type I Collagen (ICTP) and anti-cyclic citrullinated peptide antibody (ACCP) in early rheumatoid arthritis (RA) diagnosis. Methods ICTP, ACCP and rheumatoid factor (RF) were detected in 150 RA patients (RA group,with 62 cases of early RA), 100 patients with other rheumatic diseases (non-RA group), and 100 healthy controls (control group). The diagnosis value of three joint indicators and single detection for early RA was analyzed with the receiver operating characteristic (ROC) curve and the area under curve (AUC). Results The optimal cut-off values of ICTP, ACCP and RF in the diagnosis for early RA were 4.15 μg/L, 27.8 U/L and 21.5 IU/ml. The sensitivities were 75.8%, 74.2% and 69.4%. And the specificities were 84.0%, 94.0% and 68.0%. ICTP and ACCP were higher in the early RA group than in the healthy control group and the non-RA group (P<0.01). The ICTP and ACCP positive rate in the different durations of disease had no statistical significance (P>0.05), while it might be used as an indicator in diagnosis of early RA. Conclusion Combined detection of ICTP and ACCP could increase the diagnostic sensitivity and specificity in early RA, and could be the ideal serological indicator for the diagnosis of early RA.