类风湿关节炎自身抗体的临床意义

目的分析类风湿因子(RF)、抗环瓜氨酸肽抗体(CCP)、抗角蛋白抗体(AKA)在RA诊断中的意义。方法选取RA患者356例,其他自身免疫性疾病150例,进行相关实验指标的测定,并对结果进行统计学分析。结果 RF、抗CCP抗体、AKA在RA患者中阳性率、灵敏度及特异度均较高,抗CCP抗体阳性组肿胀关节数、压痛关节数、C反应蛋白(CRP)、28个关节疾病活动度评分(DAS28)、RF高于抗CCP抗体阴性组,2组比较P<0.05,差异有统计学意义。结论联合检测RF、抗CCP抗体、AKA有助于RA的诊断和鉴别诊断,且抗CCP抗体和RA疾病活动度有关。

Clinical features of autoimmune antibodies in rheumatoid arthritis

Objective To explore the clinical significance of rheumatoid factor （RF）, anti-cyclic citrullinated peptide antibodies （anti-CCPs） and anti-keratin antibody （AKA） in patients with rheumatoid arthritis （RA）. Methods We analyzed the three antibodies in 356 patients with RA and 150 with other autoimmune diseases, which allowed statistic analysis. Results The positivity, sensitivity and specificity of the RF, anti-CCPs and AKA were significantly higher in RF than in other autoimmune diseases （all P〈0.05）. The swollen joint count （SJC）, tenderness joint count （TJC）, CRP, DAS28 and the titer of RF were higher in the anti-CCPs positive group than in anti-CCPs negative group （all P〈0.05）. Conclusion The combination of RF, anti-cyclic citrullinated peptide and AKA may have diagnostic val-ue in early-stage RA. The level of anti-CCPs is associated with the disease activity of RA.