血清RF、抗CCP抗体及MMP-3联合检测在类风湿关节炎早期诊断中的应用

摘要

目的 分析类风湿性关节炎(RA)患者血清类风湿因子(RF)、抗环瓜氨酸肽(CCP)抗体及基质金属蛋白酶(MMP)-3的变化特点,提高RA的临床诊断率.方法 将确诊为RA的81例患者作为RA组,另选择80例非RA患者作为对照.采用全自动生化分析仪及酶联免疫吸附测定(ELISA)检测其血清RF、抗CCP抗体及MMP-3,以诊断敏感性、特异性、漏诊率、误诊率分析RF、抗CCP抗体、MMP-3的诊断价值.结果 RA组患者血清RF、抗CCP抗体、MMP-3水平均显著高于对照组,差异有统计学意义(P<0.01).RF、抗CCP抗体、MMP-3特异性分别是71.3%、95.0%、85.0%;敏感性分别是74.1%、67.9%、56.8%;串联方式联合检测对RA诊断的敏感性较低(35.8%),但其特异性升高(100.0%);并联方式联合检测对RA诊断的敏感性明显提高(90.1%),而特异性有所减低(61.3%).结论 血清RF、抗CCP抗体、MMP-3联合检测可提高RA诊断的准确性.%Objective To improve the accuracy rate of clinical diagnosis of rheumatoid arthritis (RA ) by analyzing characteristics of changes of serum rheumatoid factor(RF) ,anti-cyclic citrullinated peptide(CCP) antibodies and matrix metalloproteinase(MMP)-3 of patients with RA .Methods Eighty-one patients with confirmed diagnosis of RA served as RA group ,and another 80 patients with non-RA as control .Automatic biochemical analyzer and enzyme-linked immunosorbent assay (ELISA ) were adopted to detect serum RF ,anti-CCP antibody and MMP-3 .Diagnostic sensitivity ,specificity ,the rate of missed diagnosis and misdiagnosis were employed to evaluate the diagnostic values of RF ,anti-CCP antibody and MMP-3 .Results Serum levels of RF ,anti-CCP antibody and MMP-3 of patients in RA group were significantly higher than those in control group with statistical significance (P<0 .01) .Diagnostic specificity of RF ,anti-CCP antibody and MMP-3 were 71 .3% ,95 .0% ,85 .0% respectively ,and their diagnostic sensitivity were 74 .1% ,67 .9% ,56 .8% respectively .Joint detection in series way showed lower diagnostic sensitivity of RA (35 .8% ) and higher specificity (100 .0% ),while joint detection in parallel way demonstrated higher diagnostic sensitivity (90 .1% ) and lower specificity (61.3% ) .Conclusion Joint detection of serum RF ,anti-CCP antibody and MMP-3 can improve the accuracy of diagnosis of RA .