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评价抗突变型瓜氨酸波形蛋白(抗MCV)在类风湿关节炎(RA)诊断中的价值。检测225例RA患者,253例其他风湿病患者以及80例正常对照血清中抗MCV、抗CCP和RF-IgM的水平,比较抗MCV、RF-IgM及抗CCP在RA的诊断中的意义。结果表明:①抗MCV、RF-IgM、抗CCP对RA的敏感性分别为90.67%、86.22%、76.00%,特异性分别为89.49%、86.79%、93.39%;②抗MCV与抗CCP检测对RF阴性RA病例的诊断有一定价值(67.74%和29.03%);③抗MCV、抗CCP与RF-IgM之间均显著相关(P<0.01);④抗MCV与年龄、病程、功能分级、压痛关节数、ESR、CRP、晨僵持续时间及Sharp评分存在相关(P<0.01或P<0.05),而与双手平均握力、肿胀关节数、DAS28无关(P>0.05)。抗MCV对RA有较高的诊断价值,同抗CCP相比较,其特异性偏低但敏感性则较高。抗MCV能一定程度反应RA的临床病情,且与关节破坏密切相关,可作为RA的血清学指标。
To evaluate the value of anti-mutant citrullinated vimentin (anti-MCV) in the diagnosis of rheumatoid arthritis (RA). The levels of anti-MCV, anti-CCP and RF-IgM in serum of 225 patients with RA, 253 patients with other rheumatic diseases and 80 normal controls were detected. The significance of anti-MCV, RF-IgM and anti-CCP in the diagnosis of RA was compared. The results showed that: ① The sensitivity of anti-MCV, RF-IgM and anti-CCP to RA were 90.67%, 86.22% and 76.00%, respectively, and the specificity were 89.49%, 86.79% and 93.39% (67.74%, 29.03%); ③The anti-MCV, anti-CCP and RF-IgM were significantly correlated (P <0.01); ④The anti-MCV was related to age, course of disease, functional grade and tenderness The number of joints, ESR, CRP, duration of morning stiffness and Sharp score were correlated (P <0.01 or P <0.05), but not with the average grip strength, the number of swollen joints and DAS28 (P> 0.05). Anti-MCV has a higher diagnostic value of RA, compared with anti-CCP, its specificity is low but the sensitivity is higher. Anti-MCV to a certain extent, the clinical manifestations of RA, and is closely related to joint destruction, can be used as serological indicators of RA.