CAJ | 학술논문

目的：评估单独或联合检测抗角蛋白抗体（AKA）、抗环瓜氨酸肽（CCP）抗体、类风湿因子（RF）IgA和 IgM 对类风湿关节炎（RA）的诊断价值。方法分别检测195例 RA 患者和195例对照者血清中的 AKA 、抗-CCP 抗体、IgA-RF 和 IgM-RF ，AKA 采用间接免疫荧光的方法检测，抗-CCP 抗体、IgA-RF 和 IgM-RF 采用酶联免疫吸附试验检测，分析上述抗体在 RA 中的敏感性和特异性，比较抗-CCP 抗体联合 IgA-RF 或（和）IgM-RF 诊断RA 的敏感性、特异性、阳性预测值和阴性预测值。结果抗-CCP 抗体、IgA-RF 和 IgM-RF 3项联合检测特异性最高。抗-CCP 抗体＋ IgA-RF 的阳性预测值（87．59％）要明显高于抗-CCP 抗体＋ IgM-RF（78．49％）。结论抗-CCP抗体与 IgA/IgM-RF 联合检测可以显著提高 RA 的诊断效能，降低误诊率。
목적：평고단독혹연합검측항각단백항체（AKA）、항배과안산태（CCP）항체、류풍습인자（RF）IgA화 IgM 대류풍습관절염（RA）적진단개치。방법분별검측195례 RA 환자화195례대조자혈청중적 AKA 、항-CCP 항체、IgA-RF 화 IgM-RF ，AKA 채용간접면역형광적방법검측，항-CCP 항체、IgA-RF 화 IgM-RF 채용매련면역흡부시험검측，분석상술항체재 RA 중적민감성화특이성，비교항-CCP 항체연합 IgA-RF 혹（화）IgM-RF 진단RA 적민감성、특이성、양성예측치화음성예측치。결과항-CCP 항체、IgA-RF 화 IgM-RF 3항연합검측특이성최고。항-CCP 항체＋ IgA-RF 적양성예측치（87．59％）요명현고우항-CCP 항체＋ IgM-RF（78．49％）。결론항-CCP항체여 IgA/IgM-RF 연합검측가이현저제고 RA 적진단효능，강저오진솔。
Objective To evaluate the value of the single or combined detection of anti-keratin antibody (AKA) ,anti-cyclic citrullinated peptide(CCP) antibody and rheumatoid factor (RF) for the diagnosis of rheumatoid arthritis(RA) .Methods Serum AKA ,anti-CCP antibody ,IgA-RF and IgM-RF were detected in 195 cases of RA and 195 controls .AKA was detected by using the indirect immunofluorescence method ,RF and anti-CCP antibody were detected by using ELISA .The specificity and sensitivity of those antibodies in RA were analyzed in the diagnosis of RA .The sensitivity ,specificity ,positive predictive value(PPV) and negative predictive value(NPV) of anti-CCP anti-body combined IgA-RF and/or IgM-RF for diagnosing RA were compared .Results The combination detection of an-ti-CCP antibody ,IgA-RF and IGM-RF had the highest specificity .The positive predictive value of anti-CCP antibody+ IgA-RF was 87 .59% ,which was significantly higher than 78 .49% of anti-CCP antibody + IGM-RF .Conclusion The combined detection of anti-CCP antibody and IgA /IgM-RF can significantly improve the diagnostic efficiency and reduce the misdiagnosis rate .