RA33/36纯化抗原检测抗体在类风湿关节炎的应用

目的探讨RA33/36抗体对类风湿关节炎(RA)的临床价值。方法以纯化的RA33/36为抗原,用免疫印迹法检测RA498例、其他风湿性疾病患者514例、正常对照50名,比较RA33/36抗体在各组人群中的阳性率,并评价其与RA患者临床和实验室指标间的关系、早期诊断及联合诊断价值。结果RA33/36抗体在RA中的灵敏度为32.93%,特异性为88.52%,在RA早期病例中阳性率为32.03%,在72例类风湿因子(RF)阴性的RA患者中有21例阳性(29.17%)。RA33/36抗体与抗环瓜氨酸肽(CCP)抗体联合检测,特异度为98.46%。RA33/36抗体阳性组和阴性组的关节肿胀数、疼痛关节数、功能分级、X线分期及其他临床指标差异无统计学意义,RF、抗核周因子(APF)、抗角蛋白抗体(AKA)、抗Sa抗体及抗CCP抗体阳性率两组差异均无统计学意义。结论RA33/36抗体对RA有较好的灵敏度和特异度,且有早期诊断价值,并对RF有补充诊断价值,与抗CCP抗体联合诊断可提高诊断的特异性,可广泛应用于RA的临床诊断。

The clinical application of anti-RA33/36 antibody in patients with rheumatoid arthritis

Objective To detect the clinical application of anti-RA33/36 antibody in patients with rheumatoid arthritis(RA).Methods Using the purified RA33/36 antigen as antigenic sources on immunoblotting,it was detected that a total number of 1012 sera from 498 patients with RA,574 patients with other rheumatic diseases and 50 healthy controls.In addition,clinical characters and laboratory indexes were collected to study the role of RA33/36 antibody in RA.Results The sensitivity and specificity of RA33/36 antibody in RA were 32.93% and 88.52%.The positive rate of RA33/36 antibody was 32.03% in early RA.Twenty-one patients had RA33/36 antibody in 72 RA patients whose RF were negtive.The specificity increased to 98.46% when RA33/36 antibody and anti-CCP were used together.The presence of RA33/36 antibody was not correlated with RF,APF,AKA,anti-Sa,anti-CCP,ESR and clinical manifestations.Conclusions RA33/36 antibody presents reasonable sensitivity with high specificity to RA and it also can be detected in early RA.RA33/36 antibody is complementary to RF in the diagnosis of RA.Simultanous detection of RA33/36 antibody and anti-CCP can notably improve the specificity.So RA33/36 antibody is valuable in the diagnosis of RA.