贵州医科大学学报

2015, v.40;No.173(02) 179-182

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三种自身抗体联合检测对类风湿关节炎早期诊断的临床价值
The Clinical Value of Early Diagnosis on Rheumatoid Arthritis by Joint-detection of Three Kinds of Autoantibodies

高科;陶娟;王继红;谢立民;
GAO Ke;TAO Juan;WANG Jihong;XIE Limin;Department of Clinical Laboratory,the First People's Hospital of Xianyang;

摘要(Abstract):

目的:分析血清中抗环瓜氨酸肽抗体(抗CCP)、抗角蛋白抗体(AKA)和类风湿因子(RF)联合检测对类风湿性关节炎(RA)的早期诊断价值。方法:以118例RA患者(RA组)、74例其它自身免疫性疾病患者(非RA组)和40例健康体检者(健康对照组)为研究对象,分别检测抗CCP、AKA、RF水平,比较单项检测、双项检测和3项联合检测对RA诊断的敏感性和特异性。结果:3指标单独检测对RA诊断的灵敏度和特异度RF为82.20%、71.62%,AKA为52.54%、90.54%,抗CCP为68.64%、89.19%;联合检测对RA诊断的灵敏度和特异度RF联合AKA为83.90%、93.24%,RF联合抗CCP为87.29%、91.89%,AKA联合抗CCP为73.73%、94.59%,3指标联合为94.92%、97.30%。结论:RA诊断中RF具有较高的敏感性,AKA和抗CCP具有较高的特异性,联合检测可以大大提高RA诊断的灵敏度和特异度,有利于RA的早期诊断。
Objective: To investigate the early diagnostic value of rheumatoid arthritis( RA) by using joint-detection of anti-cyclic citrullinated peptide antibody( anti CCP),anti keratin antibody( AKA)and rheumatoid factor( RF) in serum. Methods: A total of 118 RA patients( RA group),74 patients with other autoimmune diseases( non RA group) and 40 healthy subjects( healthy control group) were selected. The levels of anti CCP,AKA,RF of each subjects were tested. The sensitivity and specificity of RA diagnosis were compared through single,double and three joint specificity detection. Results: Sensitivity and specificity for the RA diagnosis by using RF,AKA and anti-CCP single detection were respectively: RF( 82. 20%,71. 62%),AKA( 52. 54%,90. 54%) and anti-CCP( 68. 64%,89. 19%). Sensitivity and specificity for combined detection were respectively: RF and AKA( 83. 90%,93. 24%),RF and anti-CCP( 87. 29%,91. 89%),AKA and anti CCP( 73. 73%,94. 59%),RF,AKA and anti CCP( 94. 92%,97. 30%). Conclusions: RF exhibits higher sensitivity for RA diagnosis,AKA and anti-CCP has higher specificity. The levels of sensitivity and specificity for RA's diagnosis are improved greatly by using combined detection,which is favorable for early clinical diagnosis of RA.

关键词(KeyWords): 关节炎,类风湿;类风湿因子;抗环瓜氨酸肽抗体;抗角蛋白抗体;诊断
arthritis,rheumatoid;rheumatoid factor;anti cyclic-citrullinated peptide antibody;antikeratin antibody;diagnosis

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作者(Author): 高科;陶娟;王继红;谢立民;
GAO Ke;TAO Juan;WANG Jihong;XIE Limin;Department of Clinical Laboratory,the First People's Hospital of Xianyang;

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