早期类风湿关节炎患者血清抗CCP抗体水平的变化及其诊断价值

摘要

Objective To investigate the change in serum anti-cyclic citrullinated peptide (anti-CCP) anti-body level and its diagnostic value in patients of early rheumatoid arthritis (RA). Methods One hundred and nine patients with early rheumatoid arthritis (RA group) in our hospital from June 2012 to May 2014, 92 patients without rheumatoid arthritis (non-RA group) and 80 healthy subjects (healthy group) were enrolled in the study. Enzyme-linked immunosorbent assay (ELISA) was used to test the anti-CCP antibody level in the three groups. Results Serum anti-CCP antibody level of RA group was (21.27 ± 10.32) IU/ml, significantly higher than that of non-RA group and the healthy group, and the differences were statistically significant (P<0.05). There was no statis-tically significant difference in serum anti-CCP antibody level between non-RA group and healthy group (P>0.05). The sensitivity of anti-CCP antibody diagnosis was 66.97%, and specificity was 84.30%, with the positive predic-tive value (+PV) of 73%, the negative predictive value (-PV) of 80.11%, and Youden index of 0.513. The receiver operating characteristic (ROC) curve for anti-CCP antibody in the diagnosis of RA was produced, with AUC=0.886, 95%confidence interval of (0.837~0.934), and the best bound value of 17.5 IU/ml. Conclusion Anti-CCP antibody levels are higher in RA patients, and anti-CCP antibody detection has a higher value in the early diagnosis of RA.%目的：探讨抗环瓜氨酸抗体(抗CCP抗体)在早期类风湿关节炎(RA)患者中的水平变化及其在诊断中的应用价值。方法选取2012年6月至2014年5月在我院就诊的早期RA患者109例(RA组)，同时选取其他风湿病患者92例(非RA组)和健康体检者80例(健康组)，采用酶联免疫吸附试验(ELISA)法检测三组受试者的抗CCP抗体水平。结果 RA组血清抗CCP抗体水平为(21.27±10.32) IU/ml，明显高于非RA组和健康组，差异均有统计学意义(P<0.05)，而非RA组和健康组血清抗CCP抗体水平比较差异则无统计学意义(P>0.05)；抗CCP抗体诊断的灵敏度为66.97%，特异度为84.30%，阳性预测值为73.00%，阴性预测值为80.11%，约登指数0.513；抗CCP抗体诊断RA的受试者工作特征(ROC)曲线，其AUC=0.886，95%置信区间0.837~0.934，抗CCP抗体诊断RA最佳界值为17.5 IU/ml。结论在RA患者中抗CCP抗体水平较高，抗CCP抗体检测对RA早期诊断有较高的价值。