抗角蛋白抗体与抗环瓜氨酸肽抗体在早期类风湿关节炎诊断中的意义比较

摘要

目的比较抗角蛋白（antikeratin antibody，AKA）抗体与抗环瓜氨酸肽（cyclic citrullinated peptides， CCP）抗体在早期类风湿关节炎诊断中的意义。方法对40例类风湿关节炎（rheumatoid arthritis，RA）患者、40例非RA患者和40例健康人采用酶联免疫吸附法（ELISA）检测抗CCP抗体，用免疫比浊法检测类风湿因子（rheumatoid factor，RF），用间接免疫荧光法检测抗AKA抗体，并作比较。结果 RA患者抗CCP抗体、抗AKA抗体、RF阳性率分别为82.5%、67.5%、90%，敏感性分别为82.5%、67.5%、90%，特异性分别为97.2%、95%、80%；非RA患者抗CCP抗体、AKA、RF的阳性率为分别2.5%、5%、32.5%；正常对照组1例抗CCP抗体弱阳性，2例AKA低滴度阳性。结论抗CCP抗体及AKA均为早期类风湿关节炎特异性诊断指标，但抗CCP抗体敏感性及特异性高于AKA，联合检测抗CCP抗体、AKA、RF有利于RA的早期诊断。%　　Objective To explore the significance of anti-kerantin antibody(AKA)and anti-cyclic citrulinated peptides in the diagnosing rheumatoid arthritis. Methods All together 40 pateins with RA ,40 pateins without RA and 40 normal controls were employed in the study. The levels of Anti-CCP and rheumatoid factors(RF)and AKA were measured by ELISA methods and indirect immune fluorescence methods,respectively. Resluts In these 40 RA pateins,the diagnosing positive rates of anti-CCP,AKA and RF were 82.5%,67.5%and 90%,respectively. The sensitiveity of anti-CCP,AKA and RF were 82.5%,67.5%and 90%,respectively. The specificity were 97.2%,95%and 80%,respectively. Whereever,the diagnosing positive rates of anti-CCP,AKA and RF in these 40 pateins without RA were 2.5%,5%and 32.5%,respectively. However, there were 1 cases showing weak positive for anti-CCP and 2 case showing weak positive of AKA. Conclusion The anti-CCP and AKA are perfect index in diagnosing rheumatoid arthritis in early periods,though the sensitivity and specificity of anti-CCP are higher than that of AKA. It is valuable to combining with anti-CCP,AKA and RF indexs in diagnosing rheumatoid arthritis during earl.