抗CCP、RA33抗体的检测在早期类风湿关节炎诊断中的应用

目的　探索抗环瓜氨酸多肽 (CCP)抗体、RA33抗体对类风湿关节炎 (RA)的早期诊断价值。方法　用ELISA法检测 31例RA、30例未分化关节炎 (早期RA)、30例其他自身免疫疾病以及 2 0例正常健康者CCP、RA33抗体 ,同时对这些标本检测类风湿因子 (RF)、抗核抗体 (ANA) ,以比较这几项指标对RA的诊断价值。结果　抗CCP、RA33抗体对RA的诊断敏感性分别为 5 1.6 %、35 .5 % ;特异性分别为 98 0 %、96 0 %。RA组CCP、RA33抗体的阳性率明显高于非RA组 ,具有显著性差异 (P <0 .0 0 5 )。早期RA组CCP抗体在RF阴性组的阳性率高于RF阳性组 ,有显著性差异(P <0 .0 5 ) ;RA和早期RA组 ,CCP抗体阳性率明显高于RA33抗体 ,具有显著性差异 (P <0 .0 0 5 )。结论　抗CCP、RA33抗体有助于RA及早期RA的诊断 ,尤其是CCP抗体对早期RA的诊断意义尤为重要。

Application of measurements of serum anti-CCP and anti-RA33 in diagnosis of early rheumatoid arthritis

Objective To determine the diagnostic value of serum anti-CCP and anti-RA33 for early rheumatoid arthritis (RA). Methods Anti-CCP and anti-RA33 were detected with ELISA in 31 patients with RA, 30 undifferentiated inflammatory arthritis (UIA,early RA),30 with autoimmune disease and 20 healthy individuals. Results For anti-CCP and anti-RA33,sensitivities were 51.6% and 35.5% respectively, specifities 98.0% and 96.0% respectively.The positive rates of anti-CCP and anti-RA33 were significantly higher in patients with RA than those of other groups (P<0.05). In the UIA ,the positive rate of anti-CCP was markedly higher in RF-negative group than in RF-positive group (P<0.05) .The positive rate of anti-CCP in group RA and UIA was remarkably higher than that of RA33 (P<0.005). Conclusion Detection of anti-CCP and anti-RA33 is helpful for diagnosis of RA,especially anti-CCP for early RA.