联合检测抗ccp、rf、抗ra33在类风湿关节炎的临床应用.pdf

第26卷1期天津医科大学学报Vol.26,No.1682020年1月JournalofTianjinMedicalUniversityJan.2020文章编号1006-8147(2020)01-0068-04联合检测抗CCP、RF、抗RA33在类风湿关节炎的临床应用！岳超，刘勤2,白虹1(1.天津医科大学基础医学院免疫学系，天津300070；2.天津市第五中心医院检验科，天津300450)摘要目的：探讨抗环瓜氨酸肽抗体(抗CCP)、类风湿因子(RF)、抗RA33抗体联合检测在类风湿关节炎(RA)诊断中意义。方法:选取在我院确诊RA患者266例、非RA风湿病患者228例(结缔组织病、强直性脊柱炎、骨关节炎、系统性红斑狼疮、干燥综合征)、健康体检者215名，检测3组抗CCPsRFs抗RA33数值，统计各指标阳性率，并进行统计学分析比较；通过Spearman相关分析探讨各指标之间的关系；ROCZ线比较各指标的诊断性能；通过平行试验与系列实验探讨3项指标联合检测RA的诊断效能。结果:RA患者各指标数值均显著高于非RA自身免疫疾病患者与健康对照组(！<0.01);Spearman相关分析显示RA患者抗CCP与抗RA33之间不存在关系，RF与抗CCP、RF与抗RA33之间存在显著相关性(P<0.01);ROCZ线分析显示，抗CCP、RF、抗RA33的AUC值分别为0.942、0.922、0.653;3项指标中，阳性率：RF>抗CCP*抗RA33,敏感度:RF>抗CCP*抗RA33，特异度：抗RA33>抗CCP>RF;平行试验敏感度增高(98.50%),但特异度降低(64.91%),系列实验敏感度为15.41%,特异度为98.68%。结论:抗CCPsRF、抗RA33联合检测可提高诊断RA的敏感度与特异性,适用于RA的早期诊断，临值关键词类风湿关节炎；抗环瓜氨酸肽抗体；类风湿因子；抗RA33中图分类号R392文献标志码AJointdetectionofanti-CCP,RFandanti-RA33inrheumatoidarthritisclinicalapplicationYUEChao1,LIUQin2,BAIHong1/1.DepartmentofImmunology,SchoolofBasicMedicalSciences,TianjinMedicalUniversity,Tianjin300070,China;2.ClinicalLaboratory,TianjinFifthCentralHospital,Tianjin300450,China)AbstractObjective：Toexplorethesignificanceandapplicationvalueofcombineddetectionofanti-cycliccitrullinatedpeptideantibody(anti-CCP),rheumatoidfactor(RF)andanti-RA33antibodyinthediagnosisofrheumatoidarthritis(RA).Methods：266patientswithRAand228patientswithnon-RArheumatism(connectivetissuedisease,ankylosingspondylitis,osteoarthritis,systemiclupuserythematosus,Sjogren'ssyndrome)and215healthypersonswereselected.Theanti-CCP,RFandanti-RA33valuesofthethreegroupsweredetected,andthepositiveratesofeachindexwerecountedandanalyzedbySpearmancorrelationanalysis.ThediagnosticperformanceofeachindexwascomparedbyROCcurve,andthediagnosticefficiencyofthethreeindexeswasexploredbyparallelexperimentandseriesexperiment.Results：ThevaluesofeachindexinRApatientsweresignificantlyhigherthanthoseinnon-RApatientswithautoimmunediseasesandhealthycontrolgroup(P<0.01);Spearmancorrelationanalysisshowedthattherewasnorelationshipbetwee