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目的探讨抗环瓜氨酸肽抗体(抗CCP抗体)、类风湿因子(RF)、抗核周因子(APF)、抗角蛋白抗体(AKA)对幼年类风湿关节炎(JRA)诊断的意义,并与类风湿关节炎(RA)进行比较。方法分别采用酶联免疫吸附试验(ELISA)、胶乳凝集法、间接免疫荧光法检测54例JRA患者、31例非RA对照组、116例成人RA患者血清中的抗CCP抗体、RF、APF、AKA。结果54例JRA患者抗CCP抗体、RF、APF、AKA的敏感性分别为61.1%、57.4%、37.0%、18.5%,特异性分别为96.8%、93.6%、96.8%、100%。抗CCP抗体与RF在JRA的敏感性差异无统计学意义,但明显高于APF、AKA;4种抗体在JRA的特异性比较差异无统计学意义。RA患者中4种抗体敏感性分别为82.3%、78.3%、48.7%、25.4%,特异性分别为95.7%、73.7%、91.6%、94.0%。4种抗体在JRA诊断中的敏感性均明显低于RA组,RF在JRA患者中特异性明显高于RA患者,而其他3种抗体的特异性在两组患者比较差异无统计学意义。结论虽然抗CCP抗体谱在JRA诊断中的敏感性不及RA组,但对JRA的诊断仍具有较好的敏感性和特异性,可用于JRA的诊断。
Objective To investigate the significance of anti-cyclic citrullinated peptide (anti-CCP), rheumatoid factor (RF), anti-nuclear factor (APF) and anti-keratin antibody (AKA) in the diagnosis of juvenile rheumatoid arthritis (JRA) And compared with rheumatoid arthritis (RA). Methods The serum levels of anti-CCP, RF, APF and AKA in 54 JRA patients, 31 non-RA controls and 116 adult RA patients were determined by enzyme-linked immunosorbent assay (ELISA), latex agglutination test . Results The sensitivity of anti-CCP antibody, RF, APF and AKA in 54 patients with JRA were 61.1%, 57.4%, 37.0% and 18.5% respectively, and the specificity was 96.8%, 93.6%, 96.8% and 100% respectively. The sensitivity of anti-CCP antibody and RF in JRA was not statistically significant, but significantly higher than that of APF and AKA. The specificity of 4 antibodies in JRA was not statistically significant. The sensitivities of the four antibodies in RA patients were 82.3%, 78.3%, 48.7% and 25.4% respectively, and the specificity was 95.7%, 73.7%, 91.6% and 94.0% respectively. The sensitivity of the four antibodies in the diagnosis of JRA were significantly lower than the RA group, RF in JRA patients was significantly higher than the RA patients, while the specificity of the other three antibodies in the two groups was no significant difference. Conclusions Although the anti-CCP antibody profile is less sensitive than the RA group in the diagnosis of JRA, it still has good sensitivity and specificity for the diagnosis of JRA and can be used for the diagnosis of JRA.