抗环瓜氨酸肽抗体对类风湿性关节炎早期诊断的应用研究

目的探讨抗环瓜氨酸肽（CCP）抗体对类风湿性关节炎（RA）早期诊断的临床意义。方法应用酶联免疫吸附试验（ELISA）对126例病程〈2年的RA患者、135例非RA患者、112名健康体检者进行抗CCP抗体的定量检测,并与类风湿因子（RF）相比较。结果抗CCP抗体在RA组的阳性率为63.5%,明显高于非RA患者组（2.2%）和健康对照组（0.0%）,抗CCP抗体的特异性（97.8%）显著高于RF（83.7%）,假阳性率（2.2%）显著低于RF（16.3%）（P均〈0.001）;抗CCP抗体阳性RA患者的红细胞沉降率（ESR）和C反应蛋白（CRP）均显著高于抗CCP抗体阴性的RA患者。对抗CCP抗体阳性而RF阴性的RA患者追踪观察表明,半年后其中42.9%的患者RF转为阳性。结论抗CCP抗体对早期RA诊断有很高的特异性,具有反映RA病情是否活动和帮助判断预后的应用价值;由于血清抗CCP抗体可以较RF先出现,具有早期诊断价值。

Application research of anti-cyclic citrullinated peptide antibody in the early diagnosis of rheumatoid arthritis

Objective To investigate the clinical significance of anti-cyclic citrullinated peptide（CCP） antibody in the early diagnosis of rheumatoid arthritis（RA）.Methods Anti-CCP antibody expression levels were detected by enzyme-linked immunosorbent assay（ELISA） and compared with the rheumatoid factor（RF） expression in 126 cases of RA patients with the disease course 2 years,135 cases of non-RA patients and 112 cases of healthy subjects.Results The positive rate of anti-CCP antibody in RA group was 63.5%,and was significantly higher than those in the non-RA group（2.2%） and the healthy control group（0.0%）.The specificity of anti-CCP antibody（97.8%） was higher than that of RF（83.7%）,while the false positive rate（2.2%） was significantly lower than that of RF（16.3%,P0.001）.Erythrocyte sedimentation rate（ESR） and C reactive protein（CRP） level in the anti-CCP antibody positive patients were significantly higher than those in the anti-CCP antibody negative RA patients.The follow-up results to the anti-CCP antibody positive and RF negative patients demonstrated that RF turned to be positive in 42.9% patients after a half year.Conclusions Anti-CCP antibody is highly specific in the early diagnosis of RA,and can reflect the disease progression and help the prognosis prediction.Because the anti-CCP antibody appears earlier than RF,anti-CCP antibody has an early diagnosis value.