多种血清学指标联合检测在诊断类风湿性关节炎中的临床价值

目的探讨类风湿因子（RF）、抗RA33抗体、抗环瓜氨酸多肽抗体（抗CCP抗体）联合检测在类风湿性关节炎（RA）中的临床应用价值。方法选取符合RA诊断标准的患者93例为RA组，其他自身免疫病组60例，健康对照组60例，分别检测其RF、抗RA33抗体、抗CCP抗体，并对结果进行统计分析。结果RF、抗CCP抗体、抗RA33抗体在RA中的灵敏度分别为88．2％、78．5％、20．4％，特异度分别为60．8％、90．8％、96．7％，抗CCP抗体的灵敏度低于RF，特异度高于RF（P〈O．05）；抗RA33抗体的灵敏度低于RF、抗CCP抗体，特异度高于RF（P〈0．05），其特异度与抗CCP抗体比较，差异无统计学意义（P〉O．05）；三项联合检测的灵敏度为90.3％，特异度为98．0％。结论联合检测RF、抗RA33抗体、抗CCP抗体可以提高对RA的诊断率，具有较高的临床应用价值。

The clinical value of combined detection of varied serum index variety serological markers in the diagnosis of rheumatoid arthritis

Objective To explore the clinical value of combined detection of varied serum index variety serological markers such as rheumatoid factors （RF）,anti RA33 antibody anti cyclic citrullinated peptide antibody （anti CCP anti- body） in diagnosis of rheumatoid arthritis （RA）. Methods 93 patients met the diagnostic criteria of RA were selected as the RA group,60 cases were selected as the other autoimmune disease group and 60 cases were selected as the healthy control group.RF, anti RA33 antibody and anti CCP antibody of them were detected respectively and the results were counted and annlyzed. Results The sensitivity of RF,anti CCP antibody,anti RA33 antibody in RA were 88.2%, 78.5%, 20.4% respectively,the specificity is 60.8%,90.8%,96.7% respectively; the sensitivity of anti CCP antibody was lower than that of RF,its specificity was higher than that of RF （P〈O.05）;the sensitivity of anti RA33 antibody was lower than that of RF and anti CCP antibody,and their specificity was higher than that of RF （P〈0.05）,and there was no statistical difference of specificity between anti RA33 antibody and anti CCP antibody （P〉0.O5）;the sensitivity of combined detec- tion of three was 90.3%,the specificity was 98.0%. Conclusion The combined detection of RF,anti-RA33 antibody and anti-CCP antibody can improve the diagnostic rate for RA and it has higher clinical application value.