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目的了解抗突变型瓜氨酸波形蛋白(MCV)抗体在类风湿关节炎(RA)诊断中的意义,并比较抗MCV抗体与类风湿因子(RF)、抗核周因子(APF)、抗角蛋白抗体(AKA)、抗环瓜氨酸多肽(CCP)抗体以及某些临床指标的相关性。方法对166例研究对象,包括74例RA患者(其中早期18例,中晚期56例),50例非RA的风湿性疾病患者,42名健康对照,应用酶联免疫吸附试验(ELISA)检测血清中的抗MCV抗体,同时检测其他相关自身抗体,结合临床资料进行分析。结果74例RA中抗MCV抗体阳性58例,对RA诊断的敏感性为78％,特异性为95％,阳性预测值和阴性预测值分别为97％和71％。抗MCV抗体阳性的平均抗体浓度依次为(552±380)U/ml(RA组),(162±63)U/ml(非RA组),(63±46)U/ml (健康对照组)。RA组的平均抗体水平较高。抗MCV抗体和抗CCP抗体相关性最强(r=0．502,P=0．000),APF、AKA次之(r=0．369、0．408,P＜0．01)。抗MCV抗体与各项临床、实验室指标间的差异无统计学意义(P＞0．05)。结论抗MCV抗体在RA中具有较高的敏感性和特异性,且较APE、AKA与抗CCP抗体相关性强,可作为RA诊断的辅助指标。抗MCV抗体可能与病情活动度、功能状态无关。
Objective To understand the significance of anti-MCV antibodies in the diagnosis of rheumatoid arthritis (RA) and to compare the anti-MCV antibodies with rheumatoid factor (RF), anti-nuclear factor (APF) Protein antibodies (AKA), anti-cyclic citrullinated peptide (CCP) antibodies and some clinical indicators. Methods A total of 166 subjects including 74 RA patients (18 in the early stage and 56 in the middle and late stage), 50 rheumatic diseases in non-RA patients and 42 healthy controls were enrolled in this study. Serum was detected by enzyme linked immunosorbent assay (ELISA) In the anti-MCV antibodies, while testing other related autoantibodies, combined with clinical data analysis. Results The anti-MCV antibodies were found in 58 of 74 RA patients. The sensitivity and specificity of RA were 78% and 95%, respectively. The positive predictive value and negative predictive value were 97% and 71% respectively. The average antibody concentrations of anti-MCV antibodies were (552 ± 380) U / ml in RA group, 162 ± 63 U / ml in non-RA group and 63 ± 46 U / ml in healthy control group . The average antibody level in RA group was higher. The correlation between anti-MCV antibody and anti-CCP antibody was the strongest (r = 0.502, P = 0.000), followed by APF and AKA (r = 0.369,0.408, P <0.01). There was no significant difference between anti-MCV antibodies and clinical and laboratory parameters (P> 0.05). Conclusion Anti-MCV antibodies have high sensitivity and specificity in RA, and are more relevant than APE, AKA and anti-CCP antibodies, which can be used as auxiliary indicators for the diagnosis of RA. Anti-MCV antibodies may not be related to disease activity, functional status.