血清抗CCP抗体和抗AKA抗体联合检测对类风湿关节炎的诊断价值

目的探讨抗环瓜氨酸肽抗体(抗CCP抗体)、抗角蛋白抗体(抗AKA抗体)检测对类风湿关节炎(RA)诊断的敏感度和特异性,以及二者联合检测在RA诊断中的应用价值。方法分别采用化学发光微粒子免疫检测法、间接免疫荧光法检测抗CCP抗体、抗AKA抗体,共检测80例RA患者,40例其他自身免疫性疾病患者和30例健康体检者。结果 RA组抗CCP抗体和抗AKA抗体的阳性率明显高于非RA组和对照组,差异具有统计学意义(P0.05)。单独检测抗CCP抗体的灵敏度为73.8%高于抗AKA抗体(41.3%),特异性为86.2%低于抗AKA抗体(95.7%),二者联合检测时敏感度和特异性均有所增高。结论抗CCP抗体对RA患者有很高的敏感度和特异性,并且与抗AKA抗体联合检测对于RA的临床诊断和预后判断具有很高的临床应用价值。

Clinical application value of combination detection of serum anti-CCP antibody and anti-AKA antibody for rheumatoid arthritis

Objective To explore the sensitivity and specificity of anti‐cyclic citrullinated peptide antibody (anti‐CCP antibody) and anti‐keratin antibody (anti‐AKA antibody) detection for diagnosing rheumatoid arthritis (RA) and the application value of their combination detection in the diagnosis and treatment of RA .Methods The chemiluminescent microparticle immunoassay and indi‐rect immunofluorescence analysis were adopted to detect anti‐CCP antibody and anti‐AKA antibody in 80 cases of RA ,40 cases of other auto‐immune diseases(AID) and 30 people undergoing the physical examination .Results The positive rates of anti‐CCP anti‐body and anti‐AKA antibody in the RA group were significantly higher than those in the non‐RA group and control group ,the differences were statistically significant (P< 0 .05) .The sensitivity of single anti‐CCP antibody detection in the RA group was 73 .8% ,which was higher than 41 .3% of anti‐AKA antibody ,while the specificity of single anti‐CCP antibody detection was 86 .2% ,which was lower than 95 .7% of anti‐AKA antibody detection .In their combined detection ,the sensitivity and specificity were increased .Conclusion The anti‐CCP antibody detection has higher sensitivity and specificity for diagnosing RA .Its combined detection with anti‐AKA antibody can avoid the missed diagnosis of atypical clinical early stage RA ,which has a higher clinical value in the diagnosis and prognosis of RA .