抗环瓜氨酸肽抗体在类风湿性关节炎中的检测及临床研究

目的检测类风湿关节炎(RA)中抗环瓜氨酸肽(CCP)抗体的阳性率,探讨抗CCP抗体在RA中的诊断价值及临床意义。方法用ELISA测定48例RA患者、45例其他系统性疾病患者及40例健康人血清中的抗CCP抗体。比较活动性RA患者与非活动性RA患者的抗CCP抗体水平。分析抗CCP抗体与RA临床症状和实验室指标的相关性。结果抗CCP抗体对RA诊断的敏感性为83.3%,特异性为95.6%;抗CCP抗体与类风湿因子无相关性,两者联合检测敏感性增加至89.6%,同时能保证较高的特异性(91.4%);抗体阳性患者与抗体阴性患者在晨僵、X线分期方面有显著性差异。不同的X线分期抗CCP抗体水平有显著性差异;活动性RA患者与非活动性RA患者抗CCP抗体水平有显著性差异。结论抗CCP抗体对RA具有良好的敏感性和特异性,抗CCP抗体与RA的活动性及病程进展相关,有助于判断RA病情。

Clinical study and detection of anti-cyclic citrullinated peptide antibody in Rheumatoid Arthritis

[Objective] To study the diagnostic value of anti-cyclic citrullinated peptide antibody(anti-CCP)and to test the correlations between anti-CCP and the severity and activity of rheumatoid arthritis (RA). [Methods] The anti-CCP was detected by ELISA in 48 cases of RA, 45 cases of other systemic diseases and 40 cases of normal people. The level of anti-CCP between the active and inactive RA patients was compared, and the correlations among the level of anti-CCP and clinical manifestations and laboratory findings were analyzed. [Results] In RA, its sensitivity was 83.3%, specificity was 95.6%. Anti-CCP was not correlated with rheumatoid factor (RF). The morning stiffness and X-ray grades in RA patients with anti-CCP were significantly different from the patients without anti-CCP. The concentration of anti-CCP was significantly different in the patients with different X-ray grades in anti-CCP positive group. The level of anti-CCP in active RA group was significantly higher than in inactive RA group. [Conclusion] Anti-CCP has a reasonable sensitivity (83.3%) and high specificity (95.6%) to diagnosis of RA. Anti-CCP positive patients seem to have a more advanced disease process, and anti-CCP is associated with activity of RA.