抗环瓜氨酸肽抗体和类风湿因子联合检测对类风湿关节炎的诊断价值研究

目的：评价抗环瓜氨酸肽抗体和类风湿因子联合检测对类风湿关节炎的早期诊断价值。方法随机选择85例类风湿关节炎患者、43例非类风湿关节炎患者及30例健康者，分别采用酶联免疫吸附法和免疫透射比浊法检测血清抗环瓜氨酸肽抗体和类风湿因子。采用诊断灵敏度、特异度、阳性预测值及阴性预测值等指标评价抗环瓜氨酸肽抗体与类风湿因子单独及联合检测对类风湿关节炎的诊断效能。结果类风湿关节炎及非类风湿关节炎患者血清抗环瓜氨酸肽抗体、类风湿因子阳性率均明显高于健康者（P＜0．05）；类风湿关节炎患者血清抗环瓜氨酸肽抗体和类风湿因子阳性率均高于非类风湿关节炎患者（P＜0．05）；抗环瓜氨酸肽抗体和类风湿因子联合检测可将类风湿关节炎的诊断灵敏度提高至91．76％。结论血清抗环瓜氨酸肽抗体和类风湿因子联合检测可提高类风湿关节炎的诊断灵敏度，对类风湿关节炎的早期诊断具有重要价值。

Clinical value of combined detection of anti-cyclic citrullinated peptide antibody and rheumatoid factor for the early diag-nosis of rheumatoid arthritis

Objective To estimate the clinical value of combined detection of anti-cyclic citrullinated peptide （anti-CCP） antibody and rheumatoid factor （RF） for the early diagnosis of rheumatoid arthritis （RA） .Methods A total of 85 RA patients ,43 non-RA patients and 30 healthy subjects were enrolled and detected for serum anti-CCP antibody and RF by enzyme-linked immunosorbent assay and immune turbidimetric assay ,respectively .Diagnostic ef-ficiency for RA of single and combined detection of these two biomarkers was evaluated based on sensitivity ,specifici-ty ,positive predictive value and negative predictive value .Results The positive rates of serum anti-CCP antibody and RF in RA patients and non-RA patients were all significantly higher than those in healthy subjects （P＆lt;0 .05） .The positive rates of serum anti-CCP antibody and RF in RA patients were higher than those in non-RA patients （P＆lt;0 .05） .The combined detection of serum anti-CCP antibody and RF could significantly increase the diagnostic sensi-tivity of RA to 91 .8% .Conclusion The combined detection of serum anti-CCP antibody and RF could significantly improve the diagnostic sensitivity of RA ,which might indicated the important clinical value of the combined detection for the early diagnosis of RA .