关节液中抗环瓜氨酸肽抗体在类风湿关节炎诊断和评估中的意义被引量：3

Significance of synovial fluid anti-cyclic citrullinated peptide antibody in the diagnosis of rheumatoid arthritis

导出

摘要目的:分析关节液中抗环瓜氨酸肽(CCP)抗体对类风湿关节炎(RA)的诊断和评估意义。方法:用ELISA法检测37例RA患者血清和关节液中的抗CCP抗体和13例对照组关节炎患者关节液中的抗CCP抗体,并测定类风湿因子(RF),记录RA患者的一些临床参数。对检测结果及临床参数进行统计分析。结果:关节液中抗CCP抗体对RA诊断的敏感度为72.9%,特异度为92.3%。RA组和对照关节炎组患者的关节液中抗CCP抗体的差异有显著性。RA组血清与关节液中抗CCP抗体的浓度高度相关(P<0.001),且关节液中抗CCP抗体与关节液中RF浓度有较高相关性(P<0.01)。RA组关节液中抗CCP抗体与病程相关,病程越长,抗CCP抗体滴度越高;而与肿胀关节数、压痛关节数、疾病活动评分(DAS28)、血清RF、红细胞沉降率(ESR)、C反应蛋白(CRP)和Steinbrocker放射线分级不相关。结论:关节液中抗CCP抗体对RA的诊断有高度特异性和较好敏感性,对其他关节炎有显著性差异,独立于一些临床参数,同时又与血清中抗CCP抗体及关节液中的RF相关。 Objective To assess the significance of synovial fluid （SF） anti-cyclic citrullinated peptide antibody （CCP） in the diagnosis of rheumatoid arthritis （RA）. Methods Anti-CCP was detected by ELISA in 37 serum and synovial fluid samples of RA patients and 13 synovial fluid samples of controls. Rheumatoid factor （RF） was also assayed. Some clinical parameters were recorded. The correlation of anti-CCP and those parameters was analyzed. Results The sensitivity and the specificity of SF anti-CCP were 72.9% and 92.3% respectively. There was significant difference in SF anti-CCP between RA patients and controls. SF anti-CCP had high correlation with serum anti-CCP （P〈0.001） and with RF in SF （P〈0.01）. SF anti-CCP had correlation with duration of disease, but had no correlation with swollen joint count, tender joint count, DAS 28, serum RF, ESR, CRP, or Steinbrocker radiographic stage. Condusions SF anti-CCP has satisfactory sensitivity and specificity in diagnosis of RA, independent from some clinical parameters, and has correlation with serum anti-CCP and RF in SF.

作者刘黎 Tran Thi To Chau 陈晓翔吕良敬陆瑜陈顺乐鲍春德

机构地区上海交通大学医学院附属仁济医院风湿科

出处《诊断学理论与实践》 2006年第4期301-303,共3页 Journal of Diagnostics Concepts & Practice

基金上海市重点学科建设项目(T0203)

关键词抗环瓜氨酸肽抗体关节液类风湿关节炎 Anti-cyclic citrullinated peptide antibody Synovial fluid Rheumatoid arthritis

分类号 R593.22 [医药卫生—内科学] R446.62 [医药卫生—诊断学]

引文网络
相关文献

参考文献13

1[1]Garcia-Berrocal B,Gonzalez C,Perez M,et al.Anticyclic citrullinated peptide autoantibodies in IgM rheumatoid factor-positive patients[J].Clin Chim Acta,2005,354(1-2):123-130.
2[2]Greiner A,Plischke H,Kellner H,et al.Association of anti-cyclic citrullinated peptide antibodies,anti-citrullin antibodies,and IgM and IgA rheumatoid factors with serological parameters of disease activity in rheumatoid arthritis[J].Ann N Y Acad Sci,2005,1050:295-303.
3[3]Sauerland U,Becker H,Seidel M,et al.Clinical utility of the anti-CCP assay:experiences with 700 patients[J].Ann N Y Acad Sci,2005,1050:314-318.
4[4]Jansen LM,van Schaardenburg D,van der Horst-Bruinsma I,et al.The predictive value of anti-cyclic citrullinated peptide antibodies in early arthritis[J].J Rheumatol,2003,30(8):1691-1695.
5[5]Us D,Gulmez D,Hascelik G.Cyclic citrullinated peptide antibodies (anti-CCP) together with some other parameters used for serologic diagnosis of rheumatoid arthritis[J].Mikrobiyol Bul,2003,37(2-3):163-170.
6[6]Arnett FC,Edworthy SM,Bloch DA,et al.The American Rheumatism Association 1987 revised criteria for the classification of rheumatoid arthritis[J].Arthritis Rheum,1988,31(3):315-324.
7[7]Mordvinov GV,Mordvinova IV.Prevalence of rheumatoid factor in the healthy population of Moldova Republic[J].Klin Lab Diagn,2000,9(12):33-35.
8[8]Bas S,Genevay S,Meyer O,et al.Anti-cyclic citrullinated peptide antibodies,IgM and IgA rheumatoid factors in the diagnosis and prognosis of rheumatoid arthritis[J].Rheumatology (Oxford),2003,42(5):677-680.
9[9]Schellekens GA,Visser H,de Jong BA,et al.The diagnostic properties of rheumatoid arthritis antibodies recognizing a cyclic citrullinated peptide[J].Arthritis Rheum,2000,43 (1):155-163.
10[10]Schellekens GA,de Jong BA,van den Hoogen FH,et al.Citrulline is an essential constituent of antigenic determinants recognized by rheumatoid arthritis-specific autoantibodies[J].J Clin Invest,1998,101(1):273-281.