摘要
目的:同时检测抗CCP抗体、APF、AKA、抗2型胶原抗体在类风湿关节炎(RA)中的敏感性及特异性,探讨四者联合检测在RA早期诊断中的意义。方法:采用ELISA检测抗CCP抗体,改良的间接ELISA法检测抗2型胶原抗体,间接免疫荧光法检测APF和AKA。共检测165例RA患者、176例非RA患者和136健康者,比较四者之间的敏感性、特异性及四者联合检测的结果。结果:4种抗体对RA的敏感性由低到高顺序为:抗2型胶原蛋白抗体(26.1%)、APF(49.1%)、AKA(50.9%)和CCP(76.9%)。对RA的特异性由高到低依次为CCP(98.1%)、AKA(97.8%)、APF(91.0%)和抗2型胶原蛋白抗体(86.2%)。CCP和AKA联合对RA的敏感性为47.3%,特异性为98.4%;CCP、AKA和APF联合对RA的敏感性为40.6%,特异性为99.0%;CCP、AKA和抗2型胶原蛋白抗体联合对RA的敏感性为26.7%,特异性为99.0%;4种抗体联合对RA的敏感性为15.8%,特异性为99.7%。结论:抗CCP抗体、APF、AKA、抗2型胶原抗体4种自身抗体对RA具有高度特异性,且在RA早期即可出现。4种抗体联合检测有助于提高RA的早期诊断率。
Objective： To investigate the specificity and sensitivity of anti- perinuclear factor （APF）, anti - keratin antibody （ AKA）, Anti - cyclic citrullinated peptide（CCP） antibody ; anti - type 2 collagen antibody by simultaneous determination and combining determination respectively for the early diagnosis of rheumatoid arthritis（RA）, Methods： One hundred and sixtyfive patients with RA, 176 patients with non-RA and 136 healthy volunteers were studied. APF and AKA were determined by indirect immunofluorescence, CCP was determined by ELISA , anti -type2 collagen antibody was determined by modified indirect ELISA. Their specificity, sensitivity and result of combining determination were compared. Results： The diagnostic sensitivity of anti - type2 collagen antibody,APF,AKA and CCP were 26.2% ,49.1% ,50.5% and 76.9%, respectively. The specificity of CCP, AKA,APF,and anti -type2 collagen antibody were 98.1%, 97.8% ,91.0% and 86.2%, respectively. The sensitivity and specificity of combining determination of CCP and AKA were 47.3% and 98.4% respectively. The sensitivity and specificity of combining determination of CCP, AKA and APF were 40.6% and 99.0% respectively. The sensitivity and specificity of combining determination of CCP , AKA and anti - type2 collagen antibody were 26.7% and 99.0% respectively. The sensitivity and specificity of combining determination of CCP,AKA , APF and anti - type2 collagen antibody were 15.8% and 99.7% respectively. Conclusin： CCP, AKA APF and anti-type2 collagen antibody have high specificity for the diagnosis of RA; they present early in patients with RA. Combining determination of CCP, AKA , APF and anti-type2 collagen antibody can improve early diagnosis of RA.
出处
《海南医学院学报》
CAS
2008年第3期271-273,284,共4页
Journal of Hainan Medical University
