摘要
目的探讨类风湿因子(RF)、环瓜氨酸多肽抗体(抗-CCP)、角蛋白抗体(AKA)及葡萄糖-6-磷酸异构酶(GPI)联合检测在类风湿关节炎(RA)诊断中的价值。方法对156例RA患者及300例对照者分别采用免疫比浊法检测血清RF、ELISA法检测抗-CCP及GPI、间接免疫荧光染色法检测AKA水平。分析各血清标记物单一及不同组合在RA诊断中的价值。结果在单一标志物检测中RF敏感度及阴性预测值最高(80.1%,88.0%),抗-CCP特异度及阳性预测值最高(80.1%,82.3%)。两项联合检测中RF+抗-CCP敏感度及阴性预测值最高(68.6%,85.0%),抗-CCP+AKA特异度最高(94.0%),RF+GPI及抗-CCP+AKA的阳性预测值最高(均为83.2%)。多项联合检测中RF+抗-CCP+GPI敏感度及阴性预测值最高(64.1%,83.5%),RF+抗-CCP+AKA+GPI特异度及阳性预测值最高(96.3%,87.9%)。结论单一标志物检测RF最为理想,两项联合检测RF+抗-CCP最理想,3项联合检测RF+抗-CCP+GPI最理想。联合检测可提高类风湿关节炎的诊断率,其中抗-CCP是检测核心。
Objective To investigate the value of combined detection of rheumatoid factor （RF） ,anti-cyclic citrullinated pep- tide antibody （anti-CCP） ,antikeratin antibody （AKA） and glucose-6-phosphate isomerase （GPI） in the diagnosis of rheumatoid ar- thritis（RA）. Methods Serum samples were obtained from 156 RA patients and 300 control subjects. The levels of RF,anti-CCP, GPI and AKA were detected by using immune turbidimetry, ELISA, ELISA and indirect immunofluorescence respectively. The values of single detection and the combination detection of these serum markers in the RA diagnosis were systemically assessed. Results RF had the highest sensitivity and negative predictive value for diggnosing RA in the single marker detection（80. 1 %,88.0%）. Anti-CCP had the highest specificity and positive predictive value of the diagnosis in the single marker detection（80.1%, 82.3 %）. RF＋ anti-CCP, RF＋ anti-CCP, anti-CCP＋ AKA, RF＋ GPI and anti-CCP＋ AKA had the highest sensitivity （68.6% ）, highest neg- ative predictive value（85.0 % ）, highest specificity（94.0 % ）, highest positive predictive value （ 83.2 % ） and highest positive predic- tive value（83.2 %）for diagnosing RA in the 2--marker detection, respectively. RF-＋-anti-CCP＋ GPI had the highest sensitivity and negative predictive value（64.1%, 83.5 % ） for diagnosing RA in the 3--marker detection respectively. RF--anti-CCP＋AKA＋GPI had the highest specificity and positive predictive value （96.3 %, 87.9 %）for diagnosing RA in 4- marker detection, respectively. Conclusion RF is most ideal in the single marker detection for diagnosing RA,the 2--marker detection of RF＋anti-CCP is most i- deal, the 3- marker detection of RF＋anti-CCP＋ GPI is most ideal. The combined detection can increase the diagnosis rate of RA, in which anti-CCP is the key for detection.
出处
《重庆医学》
CAS
北大核心
2015年第13期1788-1789,1793,共3页
Chongqing medicine
关键词
类风湿关节炎
类风湿因子
环瓜氨酸肽抗体
葡萄糖-6-磷酸异构酶
rheumatoid arthritis
rheumatoid factor
anti-cyclic citrullinated peptide antibody
glucose-6-phosphate isomerase
