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类风湿因子及相关自身抗体对类风湿关节炎的诊断价值 被引量:6

Value of Rheumatoid Factor and Associated Autoantibodies in the Diagnosis for Rheumatoid Arthritis
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摘要 目的探讨类风湿因子(RF)、抗环瓜氨酸肽抗体(抗CCP)及抗角蛋白抗体(AKA)联合检测对类风湿关节炎(RA)的临床诊断价值。方法对80例RA和65例非RA的其他自身免疫病患者检测RF、RF-IgM、抗CCP及AKA 4种指标。结果自身免疫性疾病女性发病较高,以RA组为甚;RA组的RF、RF-IgM、抗CCP及AKA高于其他自身免疫性疾病组;单指标检测RA诊断的敏感性为RF>RF-IgM>AKA>抗CCP,特异性为RF-IgM>抗CCP>RF>AKA。阳性预测值为抗CCP>RF>RF-IgM、AKA,阴性预测值为RF>RF-IgM>AKA>抗CCP;以并联或串联方式联合检测均以RF、RF-IgM及抗CCP三联及RF、RF-IgM、抗CCP及AKA四联检测为佳,并联检测的敏感性分别为93%及97%,串联检测的特异性分别为98%及99%。结论 RF、RF-IgM、抗CCP及AKA 4种指标联合检测可提高对RA诊断的敏感性和特异性,对RA的早期诊断有较高价值。 Objective To evaluate the clinical significance of combined detection of anti-cyclic citrullinated peptide antibody(anti-CCP),anti-keratin antibody(AKA) and rheumatoid factor(RF) in the diagnosis of rheumatoid arthritis(RA).Method RF,RF-IgM,anti-CCP antibodies and AKA were detected in 80 RA patients and 65 non-RA patients of autoimmune diseases.Results A higher incidence of autoimmune disease was in women,and the RA group was the highest.RF,RF-IgM,anti-CCP and AKA of RA group were significantly higher than other autoimmune disease.The sensitivity of these indicators for RA diagnosis was RFRF-IgMAKAanti-CCP,and the specificity was RF-IgManti-CCP RFAKA when detected separately.Positive predictive value was anti-CCP RF RF-IgM,AKA.Negative predictive value was RF RF-IgM AKA anti-CCP.The three combined detection of RF,RF-IgM and anti-CCP and the four combined detection of RF,RF-IgM,anti-CCP,and AKA were better in parallel or in series.The sensitivity of 3 and 4 combined detection in parallel was 93% and 97%,respectively,while the specificity of serial detection was 98% and 99%,respectively.Conclusion Combined detection of the four indicators(RF,RF-IgM,anti-CCP,AKA) can improve the diagnostic sensitivity and specificity of RA,and have higher value in the early diagnosis.
作者 朱逸文 陶怡
出处 《热带医学杂志》 CAS 2010年第11期1296-1298,共3页 Journal of Tropical Medicine
关键词 类风湿关节炎 类风湿因子 抗环瓜氨酸肽抗体 抗角蛋白抗体 rheumatoid arthritis rheumatoid factor anti-cyclic citrullinated peptide antibody anti-keratin antibody
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