抗环瓜氨酸肽抗体对类风湿关节炎的诊断价值.docx

抗环瓜氨酸肽抗体对类风湿关节炎的诊断价值[摘要]目的：探讨抗环瓜氨酸肽（cycliccitrullinatedpeptideCCP）抗体在类风湿关节炎（rheumatoidarthritisRA）患者中的水平变化及临床应用价值。方法：收集RA患者血清68例并以68例非RA患者血清作对照。采用双抗体夹心酶联免疫吸附法测定血清抗-CCP抗体同时检测特种蛋白类风湿因子（RF）进行统计学分析。结果：抗-CCP抗体的特异性（95.6%）明显高于RF（69.1%）RA组患者两项指标的阳性率明显高于非RA组患者（P0.05）。联合检测敏感性（47.1%）较单独检测有所减低但特异性增高明显高达100.0%。结论：抗-CCP抗体在诊断RA中有很高的特异性联合检测RF可以早期诊断RA提高RA诊断率。动态监测抗-CCP抗体RF有助于观察RA病情变化。[关键词]类风湿关节炎；抗环瓜氨酸肽抗体；类风湿因子[中图分类号]R593.22[文献标识码]B[文章编号]1673-7210（2011）11（b）-084-02Studyondiagnoticvaluesofserumanti-CCPantibodyforpatientswithrheumatoidarthritisHUJimeiZHONGYanhuaDENGLizhengLIANGHaiyanDepartmentofLaboratorytheCentralHospitalofConghuaCityGuangdongProvinceConghua510900China[Abstract]Objective:Toinvestigatethechangalandclinicalvaluesofserumanti-CCPantibodyinpatientswithrheumatoidarthritis.Methods:Theserumof68RApatientswascollectedandtheserumof68non-RApatientswasascontrolgroup.Theserumanti-CCPantibodyandRFlevelsofpatientswithrheumatoidarthritisandwithotherrheumaticdiseaweremeasuredandanalyzed.Results:Thespecificityofanti-CCPwashigherthanthatofRF(95.6%vs69.1%).ThepositiveratesoftheindexinRAgroupwerehigherthanthoseinnon-RAgroup(P0.05).Thesensitivitywas47.1%(lowerthansingledetection)andthespecificitywas100.0%withcombineddeterminationofRFandanti-CCP.Conclusion:ThespecificityofAnti-CCPishighinthediagnosisofRAmonitoringanti-CCPandRFcanbeasthesensitiveindextodiagnoseRAanditsoutcome.ItcanobserveclinicalsymptomofRAbymonitoringanti-CCPandRF.[Keywords]Rheumatoidarthritis;Anticycliccitrullinatedpeptideantibody;Rheumatoidfactor类风湿性关节炎（rheumatoidarthritisRA）是一种以关节滑膜炎为特征的慢性全身性自身免疫性疾病是一种最常见自身免疫性疾病也是最多发的慢性炎症性关节疾病在全世界大约有1%的人患有此病其中75%是女性。其特征为滑膜出现炎症炎症对称性地从小关节进展到大关节最终在疾病后期导致关节损坏、并伴有软组织损伤。早期症状有关节红、肿、热、痛和功能障碍并且在关节部位有晨僵[1]晚期关节可出现不同程度的僵硬畸形并伴有骨和骨骼肌的萎缩极易致残。RA早期、可靠的诊断对