类风湿因子和抗环瓜酸抗体联合检测对类风湿关节炎的诊断价值及与疾病活动的相关性(1)
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[摘要] 目的:比较类风湿因子(RF)和抗环瓜酸抗体(抗CCP抗体)在类风湿关节炎(RA)诊断及预测疾病活动性中的价值。方法：采用酶联免疫吸附法(ELISA)、速率散射比浊法检测RF和抗CCP抗体，比较它们单独或联合诊断RA的价值，分析RF和抗CCP抗体与疾病活动性的相关性。结果：RF和抗CCP抗体诊断RA的敏感性分别为81.5%和95.4%，特异性分别为58.8%和95.6%，联合诊断RA特异性增高；RF和抗CCP抗体均与C反应蛋白、红细胞沉降率显著相关。结论：RF联合抗CCP抗体应用可进一步提高RA的诊断准确性，RF和抗CCP抗体与RA疾病活动性密切相关。
[关键词] 类风湿关节炎； 抗环瓜酸抗体； 类风湿因子； 疾病活动性
[中图分类号] R392.11 [文献标识码] A [文章编号] 1671-7562(2011)01-0059-03
doi:10.3969/j.issn.1671-7562.2011.01.018
[收稿日期] 2010-10-05 [修回日期] 2010-11-28
[作者简介] 李雪飞(1971-),男，江西广昌人，主治医师，医学硕士。E-mail: hillli09@163.com
[通信作者] 任敏 E-mail: minren2007@yahoo.com.cn
Rheumatoid factor and anti-cyclic citrullinated peptides antibody in
diagnosing significance in patients with rheumatoid arthritis
and their correlation with disease activity
LI Xue-fei1, WU Jia-biao, REN Min
(Department of Rheumatology, Affiliated Wujin Hospital of Jiangsu University, Changzhou 213002, China)
[Abstract] Objective: To evaluate the diagnostic significance through detecting rheumatoid factor(RF-IgM) and anti-cyclic citrullinated peptide(CCP) antibody and their correlation with disease activity. Methods: We used enzyme-linked immunosorbent assay and rate nephelometry to detect CCP and RF in patients with 65 RA, 68 non-RA. Results: The sensitivity for RF and anti-CCP were 81.5% and 95.4%, respectively, and the specificity were 58.8%, 95.6%, respectively. The specificity was increased by combining the tests. A significant correlation was found between RF, anti-CCP and CRP, ESR, respectively. Conclusion: The higher specificity was achieved by combining the tests. There was an association between RF, anti-CCP and disease activity.
[Key words] rheumatoid arthritis； anti-CCP antibody； rheumatoid factor； disease activity
类风湿关节炎(RA)是一种以慢性进行性关节滑膜病变为特征的自身免疫性疾病。其早期临床症状不典型，起病隐匿且复杂多变，发病两年内即可发生骨关节结构不可逆损害，因此早期诊断、早期应用改善病情药(DMARDS)显得尤为重要。本研究通过检测65例RA患者和68例对照血清中的抗环瓜酸抗体(抗CCP抗体)和类风湿因子(RF)水平，探讨它们单独或联合使用诊断RA的价值；同时，我们还研究了抗CCP抗体和RF与RA疾病活动性的关系，以期早期预测RA关节损伤。
1 资料与方法
1.1 病例来源
RA患者组65例，选自2008至2010年我院风湿科门诊和住院部，其中男13例，女52例，男女比例1∶4，年龄20岁～84岁，平均59.3岁。患者均符合1987年美国风湿病协会(ACR)修订的RA诊断标准 ......
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