抗环瓜氨酸肽抗体对类风湿关节炎诊断的临床评价

目的 评价抗环瓜氨酸肽(cyclic citrullinated peptides,CCP)抗体诊断类风湿关节炎(rheumatoid arthritis,RA)的敏感性和特异性.方法 收集血清标本共271例,包括89例RA患者,102例非RA性自身免疫性疾病患者,80例健康对照血清,每例标本分别检测抗-CCP抗体,抗角蛋白抗体(antikeratin antibody,AKA)和类风湿因子(rheumatoid factor,RF).抗-CCP分别与AKA、RF进行敏感性和特异性的比较.同时比较了AKA联合抗-CCP的敏感性与特异性.结果 抗-CCP、AKA、RF的敏感性分别为75.2%、70.8%、89.9%;特异性分别为94.12%、89.22%、51.96%.抗-CCP在用于诊断RA时分别与AKA、RF比较,敏感性与RF差异无统计学意义,特异性高于AKA,但未达到统计学水平;特异性与AKA差异无统计学意义,但显著高于RF.抗-CCP联合AKA在诊断RA时,阳性检出率由75.2%提高到82.02%.结论 抗-CCP诊断RA敏感性好、特异性高,有很好的临床应用价值.

Clinical evaluation of anti-cyclic citrullinated peptides in diagnosing rheumatoid arthritis

Objective To evaluate the sensitivity and specificity of anti-cyclic citrullinated peptide antibody(anti-CCP),anti-keratin antibody(AKA),rheumatoid factor(RF) in the diagnosing rheumatoid arthritis(RA).Methods Anti-CCP,AKA and RF in 89 patients with RA and in 102 patients without RA and in 80 normal controls were measured by ELISA,indirect immune fluorescence and the rate scatting immunity method.Results The sensitivity of anti-CCP,AKA and RF in the diagnosing of RA was 75.2%,70.8%,89.9%,respectively.The specificity was 94.12%,89.22%,51.96%,respectively.There was no statistical difference in the sensitivity between anti-CCP and AKA,and RF(P>0.05).As to the specificity,there was no statistical difference between anti-CCP and AKA,while the specificity of anti-CCP was significant higher than that of RF(P<0.05).The positive rate of anti-CCP associated AKA was 82.02%,a little higher than that of single anti-CCP.Conclusion The anti-CCP presents a good sensitivity and specificity in the diagnosis of RA.