类风湿因子与抗角蛋白抗体联合检测类风湿关节炎的诊断探讨

目的探讨抗角蛋白抗体(AKA)和血清类风湿因子(RF)联合检测诊断类风湿关节炎(RA)的临床应用。方法对125例RA和159例结缔组织病患者(CTD)采用散射比浊定量与荧光染色法测定RF与AKA。结果血清RF阳性率在RA组与CTD组分别为85.6%(107/125)和29.6%(47/159);AKA阳性率在RA组与CTD组分别为48.8%(61/125)和6.9%(11/159);RF和AKA两种方法对RA的诊断分别特异性是70.4%和93.1%、阳性预测值是69.5%和84.7%、阴性预测值是86.1%和69.8%。对89例RA患者血清的RF与AKA同时进行比较分析,两种方法差异具有显著意义(P<0.025)。结论RF的检测灵敏度高于AKA,但其特异性则不如,RF是类风湿关节炎诊断中较好过筛试验。AKA对RA的诊断具有满意的敏感性与特异性,是病情活动早期及严重的指标,可与RF联合检测作为RA的诊断。

Investigation of value of rheumatoid factor and antikeratin antibody in diagnosing Rheumatoid arthritis

Objective]To study the value of the rheumatoid factor and antikeratin antibody in diagnosing Rheumatoid arthritis. 125 RA and 159 CTD of Serum RF, ATK levels were measured by the nephelometry quantitative and immunolabelling technique qualitative. The RF positive of the RA group and CTD group were 85.6%, 29.6% respectively. The AKA positive of the RA group and the CTD group were 48.8%. 6.9% respectively. The AKA sensitivity was respectively 48.8% in the RA group and 6.9% in the CTD group. The RF was 70.4% and the CTD was 93.1% in the RA group specificity. the two differences were statistically significant (P <0.025). Conclusion] RF sensitivity was higher than AKA. RF positive was less than AKA.