CAJ | 학술논문

目的：分析评价类风湿关节炎（RA）患者抗环瓜氨酸抗体（Anti-CCP）、类风湿因子（RF）、C 反应蛋白（CRP）、红细胞沉降率（SR）等4个实验室指标的临床诊断意义。方法采用电化学发光法定量测定 Anti-CCP，免疫速率散射比浊法定量检测RF、CRP，仪器法检测 SR，分别将2013年来该院就诊的90例 RA 患者、93例非 RA 患者的血清进行检测，通过 ROC 曲线对测定结果进行统计和综合分析评价。结果经检测，RA 组与非 RA 组比较 Anti-CCP、RF 水平差异具有统计学意义（P ＜0.05），CRP、SR 水平差异不具有统计学意义（P ＞0.05）。Anti-CCP、RF、CRP、SR 曲线下面积（AUC）分别为94.0％、84.0％、51.7％和56.5％；Anti-CCP 和 RF 的敏感度分别为90.0％和74.4％，特异度分别为94.6％和86.0％，Youden 指数分别为84.6％和60.4％；CRP 诊断敏感度仅为52.2％，SR 诊断特异度仅为50.5％。结论 Anti-CCP、RF 对 RA 具有良好的诊断价值，且 Anti-CCP诊断性能优于 RF；CRP 和 SR 诊断性能差，仅可作为疾病进展辅助参考，联合检测以上指标对类风湿关节炎的诊断更具临床意义。
목적：분석평개류풍습관절염（RA）환자항배과안산항체（Anti-CCP）、류풍습인자（RF）、C 반응단백（CRP）、홍세포침강솔（SR）등4개실험실지표적림상진단의의。방법채용전화학발광법정량측정 Anti-CCP，면역속솔산사비탁법정량검측RF、CRP，의기법검측 SR，분별장2013년래해원취진적90례 RA 환자、93례비 RA 환자적혈청진행검측，통과 ROC 곡선대측정결과진행통계화종합분석평개。결과경검측，RA 조여비 RA 조비교 Anti-CCP、RF 수평차이구유통계학의의（P ＜0.05），CRP、SR 수평차이불구유통계학의의（P ＞0.05）。Anti-CCP、RF、CRP、SR 곡선하면적（AUC）분별위94.0％、84.0％、51.7％화56.5％；Anti-CCP 화 RF 적민감도분별위90.0％화74.4％，특이도분별위94.6％화86.0％，Youden 지수분별위84.6％화60.4％；CRP 진단민감도부위52.2％，SR 진단특이도부위50.5％。결론 Anti-CCP、RF 대 RA 구유량호적진단개치，차 Anti-CCP진단성능우우 RF；CRP 화 SR 진단성능차，부가작위질병진전보조삼고，연합검측이상지표대류풍습관절염적진단경구림상의의。
Objective To evaluate the clinical diagnostic significance of clinical laboratory indexes of anti-CCP,rheumatoid factor (RF),C reactive protein(CRP)and erythrocyte sedimentation rate(SR)in rheumatoid arthritis.Methods Anti-CCP,RF and CRP were quantitatively tested in 90 patients confirmed as rheumatoid arthritis(RA)and 93 patients with non-rheumatoid arthritis(non-RA)diseases by the electrochemiluminescence immunoassay(ECLIA),immunization rate scattering turbidimetry,etc.T test results were performed the statistical and comprehensive analysis by using the ROC curves.Results The levels of anti-CCP and RF had statistical differences between the RA group and the non-RA group(P <0.05 ),while there was no statistically significant differ-ences in the levels of CRP and SR(P >0.05 ).The areas under ROC curves(AUC)of anti-CCP,RF,CRP and SR were 94.0%, 84.0%,51.7% and 56.5% respectively;the sensitivity of anti-CCP and RF was 90.0% and 74.4% respectively,while the specifici-ty was 94.6% and 86% respectively;the Youden indexes were 84.6%and 60.4% respectively;the diagnostic sensitivity of CRP was only 52.2% and the diagnostic specificity of SR was only 50.5%.Conclusion Anti-CCP and RF have the good diagnostic value for RA,moreover the diagnostic performance of anti-CCP is better than RF;CRP and SR have the poor diagnostic preformance,the combination of above indexes has more clinical significance for diagnosing RA.