抗环瓜氨酸肽抗体、抗角蛋白抗体及类风湿因子联合检测在类风湿关节炎诊断中的应用

摘要

Objective To explore the significance of application of combination of three kinds of autoantibodies in diagnosis of patients with rheumatoid arthritis. Methods A total of 135 patients with rheumatoid arthritis(RA)and 135 patients with other autoimmune diseases were allocated in this study. The diagnostic significance of detection of anti - CCP antibody,anti - keratin antibody(AKA)and rheumatoid factor (RF)alone or combination were undertaken and compared. Results The sensitivity of RF was higher with the percentage of 75. 56% ,but its specificity(79. 26% )was not high. The specificity of AKA and anti - CCP antibodies was better(96. 30% and 97. 78% ),but their sensitivity was not high. The combined detection of 3 kinds of autoantibodies obtained a higher diagnostic significance with sensitivity of 73. 33% ,specificity of 97. 03% ,and Youden index of 0. 746. The area under the ROC curve was 0. 75. Conclusion The detection with combination of these three kinds of antibodies has higher diagnostic significance in diagnosis of patients with rheumatoid arthritis,hence it is worthy to be clinically applied.%目的：探讨抗环瓜氨酸肽（CCP）抗体、抗角蛋白抗体（AKA）及类风湿因子（ RF）联合检测在类风湿关节炎（RA）诊断中的应用。方法选择 RA 患者共135例以及非 RA 的其他风湿免疫性疾病患者共135例；采用抗CCP 抗体、AKA 与 RF 单独检测以及三种自身抗体联合检测的方法，比较诊断效能。结果 RF 获得了较高的敏感度（75.56%），但是特异度不高（79.26%）；AKA 和抗 CCP 抗体获得了较好的特异度（96.30%与97.78%），但是敏感度并不高。三种自身抗体联合检测的方法获得了较高的诊断效能，敏感度73.33%，特异度97.03%，阳性预测值96.17%，阴性预测值78.44%，约登指数0.746，ROC 曲线下面积0.75。结论抗 CCP 抗体、AKA 与 RF 联合检测对 RA 具有较高的诊断价值，值得临床推广应用。