四项指标联合检测在类风湿关节炎诊断中的价值

目的:分析类风湿因子(RF)、抗角蛋白抗体(AKA)、抗环瓜氨酸肽抗体(抗CCP抗体)、抗瓜氨酸化波形蛋白(MCV)抗体在类风湿性关节炎(RA)患者血清中的表达及其对疾病的诊断价值。方法:收集80例RA患者6、1例非RA风湿病患者以及30例健康成人的血清标本,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MCV和抗CCP抗体,免疫荧光法检测AKA,并对结果进行分析。结果:RA患者的4项抗体阳性率均明显高于非RA患者,差异有统计学意义(P<0.05),串联检测对RA诊断的敏感度下降,特异度升高至99.4%。结论:抗MCV诊断RA的灵敏度最高,抗CCP的特异度最高,RF+抗MCV+AKA和RF+抗MCV+抗CCP的联合检测可降低单项检测造成的漏诊,提高诊断的特异度。

Diagnostic Value of Four Auto-antibodies in Patients with Rheumatiod Arthritis

Objective To investigate the level of four auto-antibodies including RF and AKA and CCP and MCV in serum of rheumatoid arthritis(RA) patients and their clinical diagnostic value in early RA.Methods The serum samples of 80 patients with RA,61non-RA rheumatic patients and 30 healthy volunteers were collected.The levels of RF and AKA were measured by the rate scatting immunity methods and immunity fluorescence technique,respectively.The expression of anti-CCP and anti-MCV were measured by ELISA methods.Results The positive rates of all four auto-antibodies in RA patients were significantly higher than those of other groups(P<0.05).The sensitivity of combined detection to RA was significantly decreased,while the specificity was increased and high to 99.4%.Conclusion Anti-MCV and anti-CCP had the highest sensitivity and specificity for laboratory diagonosis of RA,respectively.The combination detection could effectively decrease the amount of missed diagnosis than single test.Especially,the combination of RF+anti-MCV+AKA and RF+anti-MCV+anti-CCP could improve the specificity,which may be helpful for clinical diagnosis.