抗CCP抗体、APF在类风湿关节炎诊断中的意义

摘要

Objective To investigate the significance of anti cyclic citrullinated peptide antibody(anti CCP), perinuclear factor(APF) in the diagnosis of rheumatoid arthritis(RA).Methods 100 patients with RA who received treatment in our hospital from June 2013 to August 2015 in our hospital were selected as the study subjects, and 100 Sjogren''s syndrome patients and 100 healthy adults were selected as the control groups.The differences of anti CCP antibody and APF positive rate were observed among the three groups.The changes of inflammatory cytokines in three groups were compared, and the specificity and sensitivity of anti CCP antibody and APF combined detection for RA diagnosis were also compared.Results The anti CCP antibody and the positive rate of APF in three groups of patients from high to low were RA group, Sjogren syndrome group and control group.The levels of IL-18, IL-6 and hs-CRP in the three groups of patients from high to low were RA group, Sjogren syndrome group and control group.The anti CCP antibody and APF positive rate of RA patients were positively correlated with IL-18 and hs-CRP levels, but no significant correlation with IL-6 levels.The sensitivity and specificity of anti CCP antibody and APF combined detection for RA were 60.53 and 68.87, which were significantly higher than the sensitivity and specificity of the above mentioned indexes.Conclusion Anti cyclic citrullinated peptide antibody and perinuclear factor positive expression rate are higher in patients with rheumatoid arthritis, and closely related to the serum levels of inflammatory cytokines and higher sensitivity and specificity of combined detection, as an important indicator of clinical detection.%目的 探讨抗环瓜氨酸肽抗体(抗CCP抗体)、抗核周因子(APF)在类风湿关节炎(RA)诊断中的意义.方法 以2013年6月至2015年8月在我院接受治疗的100例RA患者为观察对象,同时选取100例干燥综合征和100例健康成年人作为对照.观察3组研究对象抗CCP抗体、APF阳性率的差异,比较炎症细胞因子水平的变化,探讨抗CCP抗体、APF联合检测对RA诊断的特异性和灵敏度.结果 3组患者抗CCP抗体、APF阳性率从高到低分别为RA组、干燥综合征组和对照组;3组患者的IL-18、IL-6和hs-CRP水平由高到低分别为RA组、干燥综合征组、对照组;RA患者的抗CCP抗体、APF阳性率与IL-18和hs-CRP水平正相关,而与IL-6水平无明显相关关系;抗CCP抗体、APF联合检测对RA诊断的灵敏度为60.53%,特异性为68.87%,明显高于上述指标单项检测时的灵敏度和特异性.结论 抗环瓜氨酸肽抗体和抗核周因子阳性表达率在类风湿性关节炎患者中较高,并与患者血清炎症细胞因子水平密切相关,且两者联合检测的灵敏度和特异性较高,可作为临床检测的重要指标.