CAJ | 학술논문

目的：评价单项检测抗环瓜氨酸肽抗体（抗CCP抗体）或类风湿因子（RF）及两者联合检测诊断类风湿关节炎（RA ）的作用。方法选取56例RA患者纳入RA组，34例非RA患者纳入非RA组，采用电化学发光免疫分析（ECLIA）测定RF与抗CCP抗体水平，比较两组RA及抗CCP抗体水平，并评价RA与抗CCP抗体单项及联合检测的诊断效能。结果 RA组患者抗CCP抗体和RF水平均高于非RA组，差异有统计学意义（均 P＜0．05）。在 RA诊断中，抗CCP抗体和RF的受试者工作特征（ROC）曲线下面积分别为0．925和0．822，抗CCP抗体的灵敏度和特异度均高于RF。与抗CCP抗体单项检测相比，抗CCP抗体／RF不能明显提高诊断灵敏度，而特异度明显下降；抗CCP抗体＋ RF特异度无明显变化，但灵敏度明显下降。结论 RA诊断中，抗CCP抗体检测优于RF ，两者联合检测不能明显提高灵敏度和特异度，建议采用单项检测抗CCP抗体诊断RA。
목적：평개단항검측항배과안산태항체（항CCP항체）혹류풍습인자（RF）급량자연합검측진단류풍습관절염（RA ）적작용。방법선취56례RA환자납입RA조，34례비RA환자납입비RA조，채용전화학발광면역분석（ECLIA）측정RF여항CCP항체수평，비교량조RA급항CCP항체수평，병평개RA여항CCP항체단항급연합검측적진단효능。결과 RA조환자항CCP항체화RF수평균고우비RA조，차이유통계학의의（균 P＜0．05）。재 RA진단중，항CCP항체화RF적수시자공작특정（ROC）곡선하면적분별위0．925화0．822，항CCP항체적령민도화특이도균고우RF。여항CCP항체단항검측상비，항CCP항체／RF불능명현제고진단령민도，이특이도명현하강；항CCP항체＋ RF특이도무명현변화，단령민도명현하강。결론 RA진단중，항CCP항체검측우우RF ，량자연합검측불능명현제고령민도화특이도，건의채용단항검측항CCP항체진단RA。
Objective To evaluate the effectiveness of using anti‐cyclic citrullinated peptide (anti‐CCP) antibody or rheumatoid factor(RF) as the single laboratory parameter for rheumatoid arthritis(RA) diagnosis ,versus to using the two parameters in com‐bination .Methods A total of 56 cases of patients with RA were enrolled into RA group ,other 34 cases of patients with out RA were enrolled into non‐RA group .Levels of anti‐CCP antibody and RF were detected by using electro‐chemiluminescence immunoas‐say(ECLIA)and compared between the two groups .And the diagnostic efficacy of single and combined detection of anti‐CCP anti‐body and RF were evaluated .Results The levels of anti‐CCP antibody and RF in the RA group were higher than those in the non‐RA group ,had statistically significant differences(P<0 .05) .In diagnosis of RA ,the areas under receiver operating characteristic (ROC)curve of anti‐CCP antibody and RF were 0 .925 and 0 .822 respectively .The sensitivity and specificity of anti‐CCP antibody were both higher than those of RF .Compared with single detection of anti‐CCP antibody ,there was no significant increase of sensi‐tivity in using anti‐CCP antibody/RF ,whereas the specificity dropped significantly .Combined detection of anti‐CCP antibody and RF ,compared with single detection of anti‐CCP antibody ,had significantly lower sensitivity ,but no significant changes were found in specificity .Conclusion Single detection of anti‐CCP antibody is more effective than RF for diagnosing RA ,while combined detec‐tion of anti‐CCP antibody and RF could not significantly improve the specificity and sensitivity .It is suggested to only use anti‐CCP antibody for diagnosis of RA .