抗环瓜氨酸肽抗体对类风湿关节炎的诊断价值(1)
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[摘要] 目的：探讨抗环瓜氨酸肽(cyclic citrullinated peptide，CCP)抗体在类风湿关节炎(rheumatoid arthritis，RA)患者中的水平变化及临床应用价值。方法：收集RA患者血清68例，并以68例非RA患者血清作对照。采用双抗体夹心酶联免疫吸附法测定血清抗-CCP抗体，同时检测特种蛋白类风湿因子(RF)，进行统计学分析。结果：抗-CCP抗体的特异性(95.6%)明显高于RF(69.1%)，RA组患者两项指标的阳性率明显高于非RA组患者(P<0.01)。RF诊断RA的敏感性(80.9%)高于抗-CCP抗体(77.9%)，但差异无统计学意义(P>0.05)。联合检测敏感性(47.1%)较单独检测有所减低，但特异性增高明显，高达100.0%。结论：抗-CCP抗体在诊断RA中有很高的特异性，联合检测RF可以早期诊断RA，提高RA诊断率。动态监测抗-CCP抗体，RF有助于观察RA病情变化。
[关键词] 类风湿关节炎；抗环瓜氨酸肽抗体；类风湿因子
[中图分类号] R593.22 [文献标识码] B [文章编号] 1673-7210(2011)11(b)-084-02
Study on diagnotic values of serum anti-CCP antibody for patients with rheumatoid arthritis
HU Jimei, ZHONG Yanhua, DENG Lizheng, LIANG Haiyan
Department of Laboratory, the Central Hospital of Conghua City, Guangdong Province, Conghua 510900, China
[Abstract] Objective: To investigate the changal and clinical values of serum anti-CCP antibody in patients with rheumatoid arthritis. Methods: The serum of 68 RA patients was collected and the serum of 68 non-RA patients was as control group. The serum anti-CCP antibody and RF levels of patients with rheumatoid arthritis and with other rheumaticdisea were measured and analyzed. Results: The specificity of anti-CCP was higher than that of RF (95.6% vs 69.1%). The positive rates of the index in RA group were higher than those in non-RA group (P<0.01). The diagnostic sensitivities of RF and anti-CCP were 80.9% and 77.9% respectively, but there was no significant difference (P>0.05). The sensitivity was 47.1% (lower than single detection) and the specificity was 100.0% with combined determination of RF and anti-CCP. Conclusion: The specificity of Anti-CCP is high in the diagnosis of RA, monitoring anti-CCP and RF can be as the sensitive index to diagnose RA and its outcome. It can observe clinical symptom of RA by monitoring anti-CCP and RF.
[Key words] Rheumatoid arthritis; Anti cyclic citrullinated peptide antibody; Rheumatoid factor
类风湿性关节炎(rheumatoid arthritis，RA)是一种以关节滑膜炎为特征的慢性全身性自身免疫性疾病，是一种最常见自身免疫性疾病，也是最多发的慢性炎症性关节疾病，在全世界大约有1%的人患有此病，其中75%是女性。其特征为滑膜出现炎症，炎症对称性地从小关节进展到大关节，最终在疾病后期导致关节损坏、并伴有软组织损伤 ......
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