AKA APF及抗CCP联合检测与类风湿关节炎的早期诊断

目的:联合检测类风湿关节炎(RA)患者血清中的抗环瓜氨酸抗体(CCP)和抗角蛋白抗体(AKA)、抗核周因子抗体(APF),探讨RA的早期诊断方法.方法:对已确诊的71例RA患者、207例非RA的自身免疫病患者同时测定抗CCP抗体(ELISA法)和AKA、APF(间接免疫荧光法).结果:AKA、APF及抗CCP抗体对早期RA的敏感性分别为46.5%、77.5%和69.0%;特异性分别为100%、100%和98.8%.CCP及APF的阳性检出率高于AKA(p＜0.01)而与类风湿因子(RF) 无差异(p=0.067).RF弱阳性或阴性的RA患者,AKA、APF及CCP可为阳性.结论:CCP抗体及APF对RA 具有较好的敏感性和高度的特异性,联合检测AKA、APF、CCP抗体可作为早期RA病人及RF阴性RA病人的早期诊断指标.

The Relation of Examing the Anti-cyclic Citrullinated Peptide Antibody Anti-keratin Antibody and Antiperinuclear Factor with the Early Diagnosing in Patients with Rheumatoid Arthritis

Objective: To exam the anti-cyclic citrullinated peptide antibody(CCP),anti-keratin antibody(AKA) and antiperinuclear factor(APF) and to evaluate the diagnosis method of the rheumatoid arthritis(RA).Method: Serum level of CCP,AKA and APF were examed simultaneously by ELISA and indirect immunofluorescence(IIF) respectively in 71 RA and 207 non-RA patients.Result: In RA patients,the sensitivity of anti-CCP,AKA and APF were 46.5%,77.5% and 69.0%,while the specificity were 100%,100% and98.8% respectively.As for sensitivity,there was a significant difference between the methods of anti-CCP,APF And AKA assay.However,no difference was found between anti-CCP,APF And RF assay.The AKA,APF and anti-CCP can be positive in the RF positive RA patients and the negative RA patients.Conclusion: Anti-CCP and APF is quite sensitive and specific in the diagnosis of RA.To exam the anti-CCP,AKA and APF may be useful factors for early positive or negative RA patients.