抗环瓜氨酸肽抗体在类风湿性关节炎诊断中的应用

目的探讨抗环瓜氨酸肽（CCP）抗体在类风湿性关节（RA）炎诊断中的应用价值。方法用酶联免疫吸附试验（ELISA）法分别检测109例RA、42例其他风湿免疫病患者及30例健康体检者血清中的抗-CCP抗体，用速率散射比浊法检测类风湿因子（RF），并进行比较分析。结果抗CC-P抗体和RF的敏感性分另q为62．4％和70．6％，差异无统计学意义（X2=3．5，P〉0．05）；抗-CCP特异性为95．8％，明显高于RF的81．9％，两者之间有显著性差异（X2=38．2，P〈0．01）。两者联合检测敏感性下降（56．0％），特异性却升高（98．6％）；两者总体符合率78．9％；抗CC—P与RF检测对RA的诊断差异无统计学意义（X2=2．8，P〉0．05），两者之间存在明显的相关性（r=0．547，P〈0．01）。结论抗-CCP抗体是诊断RA的一个高度特异性指标，有很好的临床应用价值。

Application of anti-cyclic citrullinated peptide in diagnosis of rheumatoid arthritis

Objective To investigate the clinical value of anti-cyclic eitrullinated peptide used in diagnosis of rheumatoid arthritis. Methods The levels of anti-cyclic citrullinated peptide and rheumatoid factor in serum obtained from 109 patients with rheumatoid arthritis,42 patients with other rheumatic immunological diseases and 30 healthy people as control were measured by ELISA. Results In rheumatoid arthritis diagnosis,the rates of sensitivity of anti-cyclic citrullinated peptide and rheumatoid factors were 62.4% and 70.6% ,showing no significant difference between them（x2=3.5, P〉0.05）. But the specificity of anti-cyclic citrullinated peptide was 95.8% and obviously higher than that of rheumatoid factor （81.9 %）（X2=38.2, P〈0.01）. The sensitivity of anti-cyclic citndlinated peptide combined with rheumatoid factor test dropped 56.0% ,but the specificity of that increased to 98.6% ,with a coincidence rate of 78.9%. Conclusions Anti-cyclic citruliinated peptide is high ly specific in diagnosis of rheumatoid arthritis s.