风湿病与关节炎
風濕病與關節炎
풍습병여관절염
Rheumatism and Arthritis
2014年
6期
15-18
,共4页
王少华%于逢春%王吉红%于文广
王少華%于逢春%王吉紅%于文廣
왕소화%우봉춘%왕길홍%우문엄
关节炎,类风湿%类风湿因子%抗环瓜氨酸肽抗体%抗角质蛋白抗体%联合检测%串联试验计算%诊断
關節炎,類風濕%類風濕因子%抗環瓜氨痠肽抗體%抗角質蛋白抗體%聯閤檢測%串聯試驗計算%診斷
관절염,류풍습%류풍습인자%항배과안산태항체%항각질단백항체%연합검측%천련시험계산%진단
arthritis,rheumatoid%rheumatoid factor%anti-CCP antibody%anti keratin antibody%joint detection%the series calculation%diagnosis
目的：探讨类风湿因子（RF）、抗环瓜氨酸多肽（CCP）抗体及抗角蛋白抗体（AKA）3种实验室检测指标在类风湿关节炎诊断中的意义。方法：对65例类风湿关节炎和65例非类风湿关节炎患者用速率散射比浊法检测RF，酶联免疫吸附法检测抗CCP抗体，间接免疫荧光染色法检测AKA，比较各指标诊断类风湿关节炎的灵敏度及特异度。结果：类风湿关节炎患者的3种指标阳性率均明显高于非类风湿关节炎患者，差异有统计学意义（P<0.05）。3种指标单独检测对类风湿关节炎诊断的灵敏度、特异度分别是RF为84.62%、72.31%，抗CCP抗体为76.92%、93.92%，AKA为58.46%、90.77%；联合检测使用串联诊断试验计算对RA诊断的灵敏度、特异度分别是RF+抗CCP抗体为73.85%、95.38%， RF+AKA为56.92%、92.31%，RF+抗CCP抗体+AKA为50.77%、98.46%；RF在抗CCP抗体、AKA分别阴性的类风湿关节炎患者中检出率分别为46.67%和33.33%；抗CCP抗体和AKA在RF阴性的类风湿关节炎患者中的阳性率分别为70.00%和50.00%。结论：对类风湿关节炎的诊断，单独检测RF和抗CCP抗体灵敏度高，抗CCP抗体和AKA特异度高，有较好的临床使用价值。3种抗体联合检测，串联试验计算特异度较高，不易误诊，可提高类风湿关节炎的诊断率。
目的：探討類風濕因子（RF）、抗環瓜氨痠多肽（CCP）抗體及抗角蛋白抗體（AKA）3種實驗室檢測指標在類風濕關節炎診斷中的意義。方法：對65例類風濕關節炎和65例非類風濕關節炎患者用速率散射比濁法檢測RF，酶聯免疫吸附法檢測抗CCP抗體，間接免疫熒光染色法檢測AKA，比較各指標診斷類風濕關節炎的靈敏度及特異度。結果：類風濕關節炎患者的3種指標暘性率均明顯高于非類風濕關節炎患者，差異有統計學意義（P<0.05）。3種指標單獨檢測對類風濕關節炎診斷的靈敏度、特異度分彆是RF為84.62%、72.31%，抗CCP抗體為76.92%、93.92%，AKA為58.46%、90.77%；聯閤檢測使用串聯診斷試驗計算對RA診斷的靈敏度、特異度分彆是RF+抗CCP抗體為73.85%、95.38%， RF+AKA為56.92%、92.31%，RF+抗CCP抗體+AKA為50.77%、98.46%；RF在抗CCP抗體、AKA分彆陰性的類風濕關節炎患者中檢齣率分彆為46.67%和33.33%；抗CCP抗體和AKA在RF陰性的類風濕關節炎患者中的暘性率分彆為70.00%和50.00%。結論：對類風濕關節炎的診斷，單獨檢測RF和抗CCP抗體靈敏度高，抗CCP抗體和AKA特異度高，有較好的臨床使用價值。3種抗體聯閤檢測，串聯試驗計算特異度較高，不易誤診，可提高類風濕關節炎的診斷率。
목적：탐토류풍습인자（RF）、항배과안산다태（CCP）항체급항각단백항체（AKA）3충실험실검측지표재류풍습관절염진단중적의의。방법：대65례류풍습관절염화65례비류풍습관절염환자용속솔산사비탁법검측RF，매련면역흡부법검측항CCP항체，간접면역형광염색법검측AKA，비교각지표진단류풍습관절염적령민도급특이도。결과：류풍습관절염환자적3충지표양성솔균명현고우비류풍습관절염환자，차이유통계학의의（P<0.05）。3충지표단독검측대류풍습관절염진단적령민도、특이도분별시RF위84.62%、72.31%，항CCP항체위76.92%、93.92%，AKA위58.46%、90.77%；연합검측사용천련진단시험계산대RA진단적령민도、특이도분별시RF+항CCP항체위73.85%、95.38%， RF+AKA위56.92%、92.31%，RF+항CCP항체+AKA위50.77%、98.46%；RF재항CCP항체、AKA분별음성적류풍습관절염환자중검출솔분별위46.67%화33.33%；항CCP항체화AKA재RF음성적류풍습관절염환자중적양성솔분별위70.00%화50.00%。결론：대류풍습관절염적진단，단독검측RF화항CCP항체령민도고，항CCP항체화AKA특이도고，유교호적림상사용개치。3충항체연합검측，천련시험계산특이도교고，불역오진，가제고류풍습관절염적진단솔。
[ABSTRACT]Objective:To investigate the significance of RF,anti-CCP antibody and AKA in the diagnosis of Rheumatoid Arthritis.Methods:RF,anti-CCP antibody and AKA of 65 cases of rheumatoid arthritis and 65 cases of non rheumatoid arthritis were detected respectively by ways of nephelometry,enzyme linked immunosorbent assay,and indirect IF staining,comparing the sensitivity and specificity of each index in the diagnosis of rheumatoid arthritis.Results:The positive rates of the 3 indexes in patients with rheumatoid arthritis were significantly higher than those without rheumatoid arthritis,the difference being statistically significant (P<0.05).The sensitivity and speciifcity of each index in diagnosis of rheumatoid arthritis were respectively 84.62%72.31%of RF,76.92%and 93.92%of anti-CCP antibody,and 58.46%and 90.77%of AKA;the compound sensitivity and speciifcity were respectively 73.85% and 95.38% of RF+ anti-CCP antibody,56.92% and 92.31% of RF+AKA,and 50.77% and 98.46% of RF+ anti-CCP antibody +AKA;the detection rates of RF in patients with negative anti-CCP antibody and AKA were respectively 46.67%and 33.33%;the positive rates of anti-CCP antibody and AKA in patients with negative RF were respectively 70% and 50%. Conclusion:In the diagnosis of rheumatoid arthritis,separate detection of RF and anti-CCP antibody has high sensitivity,and anti-CCP antibody and AKA have high specificity,worthy of clinical application.While combined detection of the antibodies has a high speciifcity,dififcult to be misdiagnosed,which can improve the diagnosis rate of rheumatoid arthritis.
