血清抗核周因子等自身抗体对早期类风湿关节炎的诊断意义

目的探讨血清抗核周因子(APF)、抗角蛋白抗体(AKA)、抗Sa抗体及抗RA33抗体对早期类风湿关节炎(RA)的诊断意义。方法对早期RA患者43例,非RA患者88例进行血清APF、AKA、抗Sa抗体及抗RA33抗体的检测,APF、AKA用间接免疫荧光法进行检测,抗Sa抗体、抗RA33抗体用免疫印记法检测。结果(1)APF、AKA、抗Sa抗体及抗RA33抗体对早期RA诊断的特异性和敏感性分别为96.6%和34.9%、94.3%和37.2%、97.7%和34.9%、97.7%和23.3%。(2)4种抗体联合检测时,2种抗体阳性、3种抗体阳性、4种抗体阳性对早期RA诊断的特异性和敏感性分别为97.7%和23.3%、98.9%和16.3%、100%和9.3%。结论APF等自身抗体对早期RA诊断的特异性高,4种抗体联合检测可提高早期RA的诊断率。

The clinical significance of detecting serum auto-antibodies in early diagnosis of Rheumatoid arthritis

Objective To evaluate the clinical significance of detecting antiperinuclear factor(APF), antikeratin antibody(AKA), anti-Sa antibody and anti-RA33 antibody in early diagonosis of rheumatoid arthritis(RA). Methods Serum APF, AKA, anti-Sa antibody and anti RA33 antibody were detected in 43 patients with early RA and 88 controls. APF and AKA were detected by immunofluorescence technique, and with anti-Sa antibody and anti RA33 antibody by immunoapot method. Results (1) In early diagonosis of RA, the sensitivities and specificities of APF, AKA, anti-Sa antibody and anti-RA33 antibody were 96.9% and 34.9%,94.3% and 37.2%, 97.7% and 34.9%, 97.7% and 23.3% respectively. (2) As combined detection of all the four auto-antibodies, the positive sensitivities and specificities of two antibodies, three antibodies and four antibodies were 97.7% and 23.3%, 98.9% and 16.3%, 100% and 9.3% respectively. Conclusions These results and previous studies proved that auto-antibody detection has high specificity for the diagnosis of RA. It is of high diagnostic rate with the co-detection method.