目的：探讨类风湿因子（ RF）、抗环瓜氨酸肽抗体（抗CCP 抗体）、抗角蛋白抗体（ AKA）联合检测对类风湿性关节炎（ RA）的诊断价值，及IgG、IgA、IgM、C3、C4在类风湿性关节炎中的意义。方法：采用免疫散射比浊法检测RF、IgG、IgA、IgM、C3、C4，采用ELISA法检测抗CCP抗体，间接免疫荧光法检测AKA的水平，并对结果进行统计学分析。结果：RA患者组RF、抗CCP 抗体、AKA、IgG、IgA、IgM、C3、C4的水平均高于健康对照组，差异具有统计学意义（ P＜0．05）；RF、抗CCP 抗体、AKA在RA诊断中的敏感度为95％、83．3％、68．3％，特异度为81．2％、96．9％、100％；RF、抗CCP 抗体、AKA联合检测串联实验的敏感性为58．3％，特异性为100％；RF、抗CCP抗体、AKA联合检测并联实验的敏感性为98．3％，特异性为78．1％。结论：以上指标对类风湿性关节炎的诊断具有参考价值；联合检测在一定程度上避免了抗CCP抗体跟AKA的敏感度低，以及RF的特异性低而造成的漏诊，为临床早期诊断断提供依据。%Objective:To evaluate the diagnostic value of combined determination of rheumatoid factor (RF), anti-cyclic citrulline peptide (anti-CCP) antibody, and antikeratin antibody (AKA) in patients with rheumatoid arthritis ( RA ) , and significance of IgG, IgA, IgM, C3 and C4 in rheumatoid arthritis. Method:Scattering method adopts immune turbidimetry was used to detect the level of RF, IgG, IgA, IgM, C3, C4 and measured the levels of anti–CCP by ELISA and measured the levels of AKA indirect immuno-fluorescence method , and the results were analyzed statisticy.Result:The level of RF, anti-CCP antibody , AKA, IgG, IgA, IgM, C3 and C4 in the serum of RA patients was higher than the normal control group, and the difference was statistically significant ( P<0.05) , the diagnostic sensitivity of The RF, anti-CCP an-tibody, AKA were 95%, 83.3%, 68.3%respectively, The specificity were 81.2%, 96.9%, 100%;sensitiv-ity of series experiments was 58.3%and the specificity was 100%with combined determination of RF, anti-CCP antibody, AKA, sensitivity of parallel experiment was 98.3%and the specificity was 78.1%with com-bined determination of RF, anti-CCP antibody, AKA .Conclusion:It has reference value to the diagnosis of rheumatoid arthritis.It's certain extent to avoid the low sensitivity of anti-CCP antibody and AKA with joint detection, and RF occur due to the specificity of diagnosis, It provids the basis for early diagnosis of RA.
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