AKA、APF、RF和抗CCP抗体在类风湿关节炎诊断和鉴别诊断中的应用

目的探讨抗核周因子抗体(APF)、抗角蛋白抗体(AKA)、类风湿因子(RF)、抗环瓜氨酸肽抗体(抗CCP抗体)联合检测在类风湿关节炎(RA)诊断和鉴别诊断中的临床应用价值。方法RA患者127例,非RA其它风湿病患者102例及正常人对照组43例,采用速率散射免疫比浊法检测RF;酶联免疫吸附法定量检测抗-CCP抗体;免疫荧光法检测AKA、APF,并采用四格表法计算敏感度及特异性。结果RA组,RF、APF、AKA、抗-CCP抗体的敏感度分别为65.4%、48.8%、32.3%、83.5%;特异性分别为73.5%、92.2%、93.1%、94.1%。同时出现3种抗体和4种抗体的特异性为99.0%、100%;非RA组,无4种抗体同时出现的情况。结论RF敏感性较高,但特异性较差;APF、AKA、抗-CCP三种自身抗体对RA具有高度特异性,且在RA早期即可出现。4种抗体联合检测有助于类风湿关节炎(RA)诊断和鉴别诊断。

Clinical value of APF, AKA, RF and anti - CCP antibody in diagnosis and differential diagnosis of Rheumatoid Arthritis

Objective To explore the clinic value of combined detection of APF,AKA,RF and anti-CCP antibody in diagnosis and differential diagnosis of rheumatoid arthritis(RA).Method RF and anti-CCP antibody were measured by the rate scatting immunity method and ELISA respectively.AKA and APF were both measured with immunity fluorescence technique in 127 patients with Rheumatoid Arthritis and 102 patients without Rheumatoid Arthritis and 43 normal persons.Sensitivity and specificity were calculated.Result The sensitivity of RF,APF,AKA,and anti-CCP antibody were 65.4%,48.8%,32.3%,83.5% respectively;The specificity of RF,APF,AKA,and anti-CCP antibody were 73.5%,92.2%, 93.1%,94.1% respectively in experimental groups.The specificity were 99.% and 100% in RA patients with three or four antibodies all positive.On the contrary,four antibodies were not all positive simultaneously in control groups.Conclusion RF has high sensitivity and low specificity in early diagnosis of RA,but APF,AKA,and anti-CCP antibody have high specificity.The combined detection of four antibodies could have great clinic value in diagnosis and differential diagnosis of rheumatoid arthritis(RA).