摘要
目的比较抗环胍氨酸肽抗体(anti-CCP)、抗角蛋白抗体(AKA)和类风湿因子(RF)诊断类风湿性关节炎(RA)的敏感性及特异性,探讨三者联合检测在RA诊断中的意义。方法收集184例RA患者和118例非RA的自身免疫病患者血清,应用酶联免疫吸附试验(ELISA)检测抗CCP,间接免疫荧光法检测AKA,颗粒增强速率散射比浊法检测RF。结果抗CCP、AKA、RF诊断RA的敏感度分别为78.5%,23.9%和67.4%,特异度分别为90.6%,90.7%和72.9%。RF、抗CCP诊断RA的ROC曲线下面积分别为0.684和0.772(P<0.01),临界值分别为10.95IU/ml和6.3RU/ml。RA患者三种抗体的阳性率均高于非RA患者,差异具有统计学意义(P<0.05)。三种抗体诊断RA的敏感度不同,差异有统计学意义(P<0.05)。三种抗体联合检测诊断RA的敏感度可达94.1%。结论诊断RA的三种相关抗体中抗CCP的敏感性最高,AKA的特异度最好,抗CCP最具诊断价值;三种抗体联合检测诊断RA的敏感度均高于任意一种或两种指标,对RA的早期诊断具有重要的应用价值。
Objective To compare the sensitivity and specificity of anti-cyclic citrullinated peptide antibody （ CCP） ,anti-keratin antibody（ AKA） and rheumatoid factor （ RF） in the diagnosis of rheumatoid arthritis （ RA） ,and to explore the clinical value of combined detection of the three auto-antibodies. Methods Serum levels of anti-CCP,AKA and RF were detected in 184 RA patients and 118 patients with other autoimmune diseases using ELISA,indirect immunofluorescence and nephelometric assay,respectively. Results The sensitivities of anti-CCP,AKA and RF were respectively 78. 5% ,23. 9% and 67. 4% ,and the specificities were respectively 90. 6% ,90. 7% and 72. 9% . The areas under ROC curve of RF and anti-CCP were respectively 0. 684 and 0. 772（ P〈0. 01） . The positive rates of the three auto-antibodies in RA patients were significantly higher than in non-RA patients （ P〈0. 05） . The sensitivity of combined detection of the three auto-antibodies was up to 94. 1% . Conclusion For the three antibodies,anti-CCP has the highest sensitivity for diagnosing RA,while AKA has the highest specificity. Combined detection of the three auto-antibodies will improve the sensitivity in the diagnosis of RA.
出处
《山西医科大学学报》
CAS
2010年第11期972-975,共4页
Journal of Shanxi Medical University
