类风湿性关节炎患者血清中自身抗体 RF、AKA 、ACII、ACCP联合检测的临床意义

目的：探讨类风湿因子（rheumatoid factor ，RF）、抗角质蛋白抗体（antikeratin antibody ，AKA ）及抗环瓜氨酸肽（anti‐cyclic citrullinated peptide ，CCP）抗体和抗II型胶原蛋白（ACII）对类风湿关节炎（rheumatoid arthritis ，RA）准确诊断的临床意义。方法检测60名RA患者，30名其他风湿性疾病患者和30名健康体检者的以上4种自身抗体，统计其阳性率，并比较这四项诊断指标的敏感性、特异性、准确率。结果 RF的敏感性最高但特异性低；以ACCP和ACII的特异性最好。试验的诊断准确性为ACCP＞ACII＞AKA＝RF。结论当有RF、ACII或ACCP、AKA 3种或3种以上抗体阳性时，特异性可达100％。4种抗体联合检测可显著提高对 RA 的诊断特异性，有助于早期 RA 的诊断和治疗。

Significance of detecting RF,AKA,ACII,ACCP in serum of patients with rheumatoid disease

Objective To investigate the clinical usefulness of combined determination of serum rheumatic factor (RF) ,anti‐kera‐tin antibody(AKA)and anti‐cyclic citrullinated peptide antibody (anti‐CCP antibody)levels and anti2type2Ⅱ2collagens antibody (ACII)for accurate diagnosis in patients with rheumatoid arthritis (RA) .Methods 60 RA patients ,30 patients of other rheumatic diseases ,30 healthy persons were tested 4 antibodies in sera .The sensitivity、specificity and accuracy of diagnostic performance of the 4 test indexes were calculated .Results The best specificity were ACCP and ACII but the high sensitivity and low specificity of the RF .The accuracy performance of these test is ACCP> ACII> AKA= RF .Conclusion When more than three of the antibody RF ,ACII or ACCP ,AKA positive ,the specificity can reach 100% .We should test the above indexes together to improve the diag‐nose accuracy of the Rheumatoid Disease .