中华检验医学杂志
中華檢驗醫學雜誌
중화검험의학잡지
CHINESE JOURNAL OF LABORATORY MEDICINE
2008年
9期
1007-1010
,共4页
陈捷%王兰兰%秦莉%武永康%彭晓东%张瑞薇%唐江涛%郑沁
陳捷%王蘭蘭%秦莉%武永康%彭曉東%張瑞薇%唐江濤%鄭沁
진첩%왕란란%진리%무영강%팽효동%장서미%당강도%정심
抗瓜氨酸化波形蛋白抗体%抗葡萄糖-6-磷酸异构酶抗体%抗环瓜氨酸肽抗体%抗角蛋白抗体%类风湿因子%类风湿关节炎
抗瓜氨痠化波形蛋白抗體%抗葡萄糖-6-燐痠異構酶抗體%抗環瓜氨痠肽抗體%抗角蛋白抗體%類風濕因子%類風濕關節炎
항과안산화파형단백항체%항포도당-6-린산이구매항체%항배과안산태항체%항각단백항체%류풍습인자%류풍습관절염
Anti-mutated citrullinated vimentin%Anti-Glucose-6-phosphate isomerase%Anticyclic citrullinated peptide antibody%Anti-Keratin antibody%Rheumatoid factor%Rheumatoid arthritis
目的 评价分析抗瓜氨酸化波形蛋白(MCV)抗体、抗葡萄糖-6-磷酸异构酶(GPI)抗体等5项指标在类风湿关节炎(RA)患者血清中的表达与疾病的相关性及应用价值.方法 收集150例BA、32例SLE、30例强直性脊柱炎(OA)、20例骨关节炎(AS)、20例干燥综合征(SS)、20例结缔组织病(CTD)患者和40名健康人血清标本.采用ELISA分析血清中抗MCV、抗GPI和抗环瓜氨酸肽(CCP)抗体水平,采用间接免疫荧光法检测抗角蛋白(AKA)抗体,采用速率散射比浊法检测类风湿因子(RF)水平.分别计算和比较单项标志物诊断RA的效能;选择高敏感度与高特异度抗体联合检测,并计算其与RF联合诊断RA的效能.结果 5种抗体在RA患者组中的阳性率显著高于疾病对照组和健康对照组(X2分别为88.5、76.0、279.2、88.2、94.8,P均<0.05).除AKA抗体阳性率较低(37.3%)外,其余抗体在RA中的阳性率差异无统计学意义(X2分别为21.9、9.4、20.2、43.2、41.6,P均>0.05).单项抗体检测中,抗MCV和抗GPI抗体的敏感度最高,分别为78.0%和83.3%,抗CCP抗体的特异度最高,为97.1%,具有高特异度(96.1%)的AKA抗体敏感度最低,仅为49.4%.抗MCV/抗CCP抗体联合检测的敏感度和特异度最高,分别为92.7%和96.9%.RF/抗GPI/抗CCP抗体联合检测的敏感度和特异度为90.7%和96.9%,RF/抗MCV/抗CCP抗体联合检测的敏感度和特异度为94.0%和96.9%.结论 抗MCV和抗GPI抗体诊断RA的敏感度最高;抗CCP抗体的特异度最高,AKA抗体虽然具有较高的特异度,但敏感度最低,联合检测可弥补单项抗体检测造成的RA漏诊,RW抗GPI/抗CCP抗体和RE/抗MCV/抗CCP抗体的组合模式可同时提高诊断RA的敏感度和特异度.
目的 評價分析抗瓜氨痠化波形蛋白(MCV)抗體、抗葡萄糖-6-燐痠異構酶(GPI)抗體等5項指標在類風濕關節炎(RA)患者血清中的錶達與疾病的相關性及應用價值.方法 收集150例BA、32例SLE、30例彊直性脊柱炎(OA)、20例骨關節炎(AS)、20例榦燥綜閤徵(SS)、20例結締組織病(CTD)患者和40名健康人血清標本.採用ELISA分析血清中抗MCV、抗GPI和抗環瓜氨痠肽(CCP)抗體水平,採用間接免疫熒光法檢測抗角蛋白(AKA)抗體,採用速率散射比濁法檢測類風濕因子(RF)水平.分彆計算和比較單項標誌物診斷RA的效能;選擇高敏感度與高特異度抗體聯閤檢測,併計算其與RF聯閤診斷RA的效能.結果 5種抗體在RA患者組中的暘性率顯著高于疾病對照組和健康對照組(X2分彆為88.5、76.0、279.2、88.2、94.8,P均<0.05).除AKA抗體暘性率較低(37.3%)外,其餘抗體在RA中的暘性率差異無統計學意義(X2分彆為21.9、9.4、20.2、43.2、41.6,P均>0.05).單項抗體檢測中,抗MCV和抗GPI抗體的敏感度最高,分彆為78.0%和83.3%,抗CCP抗體的特異度最高,為97.1%,具有高特異度(96.1%)的AKA抗體敏感度最低,僅為49.4%.抗MCV/抗CCP抗體聯閤檢測的敏感度和特異度最高,分彆為92.7%和96.9%.RF/抗GPI/抗CCP抗體聯閤檢測的敏感度和特異度為90.7%和96.9%,RF/抗MCV/抗CCP抗體聯閤檢測的敏感度和特異度為94.0%和96.9%.結論 抗MCV和抗GPI抗體診斷RA的敏感度最高;抗CCP抗體的特異度最高,AKA抗體雖然具有較高的特異度,但敏感度最低,聯閤檢測可瀰補單項抗體檢測造成的RA漏診,RW抗GPI/抗CCP抗體和RE/抗MCV/抗CCP抗體的組閤模式可同時提高診斷RA的敏感度和特異度.
목적 평개분석항과안산화파형단백(MCV)항체、항포도당-6-린산이구매(GPI)항체등5항지표재류풍습관절염(RA)환자혈청중적표체여질병적상관성급응용개치.방법 수집150례BA、32례SLE、30례강직성척주염(OA)、20례골관절염(AS)、20례간조종합정(SS)、20례결체조직병(CTD)환자화40명건강인혈청표본.채용ELISA분석혈청중항MCV、항GPI화항배과안산태(CCP)항체수평,채용간접면역형광법검측항각단백(AKA)항체,채용속솔산사비탁법검측류풍습인자(RF)수평.분별계산화비교단항표지물진단RA적효능;선택고민감도여고특이도항체연합검측,병계산기여RF연합진단RA적효능.결과 5충항체재RA환자조중적양성솔현저고우질병대조조화건강대조조(X2분별위88.5、76.0、279.2、88.2、94.8,P균<0.05).제AKA항체양성솔교저(37.3%)외,기여항체재RA중적양성솔차이무통계학의의(X2분별위21.9、9.4、20.2、43.2、41.6,P균>0.05).단항항체검측중,항MCV화항GPI항체적민감도최고,분별위78.0%화83.3%,항CCP항체적특이도최고,위97.1%,구유고특이도(96.1%)적AKA항체민감도최저,부위49.4%.항MCV/항CCP항체연합검측적민감도화특이도최고,분별위92.7%화96.9%.RF/항GPI/항CCP항체연합검측적민감도화특이도위90.7%화96.9%,RF/항MCV/항CCP항체연합검측적민감도화특이도위94.0%화96.9%.결론 항MCV화항GPI항체진단RA적민감도최고;항CCP항체적특이도최고,AKA항체수연구유교고적특이도,단민감도최저,연합검측가미보단항항체검측조성적RA루진,RW항GPI/항CCP항체화RE/항MCV/항CCP항체적조합모식가동시제고진단RA적민감도화특이도.
Objective To investigate the level of five auto-antibodies including MCV and GPI in the serum of RA patients and assess the application value of five auto-antibodies in RA diagnosis.Methods The five auto-antibodies were detected by ELISA in serum samples of 150 patients with RA and 40 healthy controls,32 patients of SLE,30 patients of OA,20 patients of AS,20 patients of SS,20 patients of CTD.Results The positive rates of these five auto-antibodies in RA patients were significantly higher than in other group(X2=88.5,76.0,279.2,88.2,94.8,P<0.05).Except anti-AKA,there was no the differences in the level of other antibodies among groups(X2=21.9,9.4,20.2,43.2,41.6,P>0.05).Anti-MCV and anti-GPI has the highest sensitivity(78.0% and 83.3%),while anti-CCP has the highest specificity(97.1%)and anti-AKA has good specificity(96.1%)and lowest sensitivity(49.4%).When two antibodies were detected together,the sensitivity and specificity of MCV/CCP were highest(92.7% and 96.9%).When RF/GPI/CCP were detected together,the sensitivity and specificity were 90.7% and 96.9%,respectively.When RF/MCv/CCP were detected together,the sensitivity and specificity were 94.0% and 96.9%.Conclusions Anti-MCV and anti-GPI has the hishest sensitivity in laboratory diagnosis of RA,while anti-CCP has the highest specificity and anti-AKA have good specificity and lowest sensitivity.The combination detection can decrease the amount of missed diagnosis caused by single test. The combination detection of RF/GPI/CCP and RF/MCV/CCP will improve sensitivity and specificity for diagnosis to the RA patients.