抗角蛋白抗体、抗环瓜氨酸多肽抗体在类风湿关节炎诊断中的应用

目的：探讨抗角蛋白抗体、抗环瓜氨酸多肽抗体间的关系及其在类风湿关节炎诊断中的意义。方法：采用ELISA法测定抗环瓜氨酸多肽抗体、间接免疫法测定抗角质蛋白抗体、乳胶凝集法测类风湿因子。共检测82例类风湿患者，80例非类风湿关节炎患者，40例正常对照。结果：82例类风湿患者中抗环瓜氨酸多肽抗体、抗角蛋白抗体、类风湿因子阳性率分别为47．6％(39／82)，32．9％(27／82)，75．6％(62／82)，非类风湿关节炎患者中抗环瓜氨酸多肽抗体、抗角蛋白抗体、类风湿因子阳性率分别为3．75％(3／80)，2．5％(2／80)，15％(12／80)，正常对照仅有1例抗环瓜氨酸多肽抗体弱阳性及1例抗角蛋白抗体低滴度阳性。结论：抗环氨酸多肽抗体和抗角蛋白抗体均是类风湿特异性诊断指标，抗环瓜氨酸多肽抗体敏感性高于抗角蛋白抗体，与类风湿因子相结合有助于提高类风湿关节炎诊断的敏感性和特异性。

Application of anti-keratin antibody and anti-CCP antibody in the diagnosis of rheumatoid arthtitis

Objective To investigate the relationship between anti-keratin antibody(AKA) and anti-cyclic aitullinated peptide antibody (anti-CCP antibody) and the diagnostic value of them in patients with rheumatoid arthritis (RA). Methods Anti-CCP antibody was tested by ELISA. AKA was checked by indirect immunofluo-rescence (IIP). Rheumatoid factor (RF) was detected emulsio agglutination. In all, 202 people were examined, including 82 patients wih RA, 80 patients with nonRA arthritis and 40 healthy controls. Results In 82 RA patients with positive anti-CCP antibody, AKA and RF were 47.6%(39/82) ,32.9%(27/82),75.6%(62/82)respectively. In 80 non-RA arthritis patients with positive anti-CCP antibody, AKA and RF were 3.75%(3/80),2.5% (2/80),15 %(12/ 80) respectively. One example in the healthy controls showed anti-CCP antibody with weak positive and one showed RF with low titer positive. Conclusion Anti-CCP antibody and AKA are all diagnostic data of RA specificity. The diagnostic sensitivity of the anti-CCP antibody was higher than AKA. Combining them with Rf could enhance the diagnostic sensitivity and specificity of RA.