RF、抗CCP抗体和AKA对类风湿关节炎诊断的实验检测分析

摘要

[ABSTRACT]Objective:To investigate the significance of RF,anti-CCP antibody and AKA in the diagnosis of Rheumatoid Arthritis.Methods:RF,anti-CCP antibody and AKA of 65 cases of rheumatoid arthritis and 65 cases of non rheumatoid arthritis were detected respectively by ways of nephelometry,enzyme linked immunosorbent assay,and indirect IF staining,comparing the sensitivity and specificity of each index in the diagnosis of rheumatoid arthritis.Results:The positive rates of the 3 indexes in patients with rheumatoid arthritis were significantly higher than those without rheumatoid arthritis,the difference being statistically significant (P<0.05).The sensitivity and speciifcity of each index in diagnosis of rheumatoid arthritis were respectively 84.62%72.31%of RF,76.92%and 93.92%of anti-CCP antibody,and 58.46%and 90.77%of AKA;the compound sensitivity and speciifcity were respectively 73.85% and 95.38% of RF+ anti-CCP antibody,56.92% and 92.31% of RF+AKA,and 50.77% and 98.46% of RF+ anti-CCP antibody +AKA;the detection rates of RF in patients with negative anti-CCP antibody and AKA were respectively 46.67%and 33.33%;the positive rates of anti-CCP antibody and AKA in patients with negative RF were respectively 70% and 50%. Conclusion:In the diagnosis of rheumatoid arthritis,separate detection of RF and anti-CCP antibody has high sensitivity,and anti-CCP antibody and AKA have high specificity,worthy of clinical application.While combined detection of the antibodies has a high speciifcity,dififcult to be misdiagnosed,which can improve the diagnosis rate of rheumatoid arthritis.%目的：探讨类风湿因子（RF）、抗环瓜氨酸多肽（CCP）抗体及抗角蛋白抗体（AKA）3种实验室检测指标在类风湿关节炎诊断中的意义。方法：对65例类风湿关节炎和65例非类风湿关节炎患者用速率散射比浊法检测RF，酶联免疫吸附法检测抗CCP抗体，间接免疫荧光染色法检测AKA，比较各指标诊断类风湿关节炎的灵敏度及特异度。结果：类风湿关节炎患者的3种指标阳性率均明显高于非类风湿关节炎患者，差异有统计学意义（P<0.05）。3种指标单独检测对类风湿关节炎诊断的灵敏度、特异度分别是RF为84.62%、72.31%，抗CCP抗体为76.92%、93.92%，AKA为58.46%、90.77%；联合检测使用串联诊断试验计算对RA诊断的灵敏度、特异度分别是RF+抗CCP抗体为73.85%、95.38%， RF+AKA为56.92%、92.31%，RF+抗CCP抗体+AKA为50.77%、98.46%；RF在抗CCP抗体、AKA分别阴性的类风湿关节炎患者中检出率分别为46.67%和33.33%；抗CCP抗体和AKA在RF阴性的类风湿关节炎患者中的阳性率分别为70.00%和50.00%。结论：对类风湿关节炎的诊断，单独检测RF和抗CCP抗体灵敏度高，抗CCP抗体和AKA特异度高，有较好的临床使用价值。3种抗体联合检测，串联试验计算特异度较高，不易误诊，可提高类风湿关节炎的诊断率。