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目的:探讨抗环瓜氨酸肽(CCP)抗体、超敏C反应蛋白(hs-CRP)和类风湿因子(RF)联合检测在类风湿性关节炎(RA)早期诊断中的应用价值。方法:选取2014-2015年在本院确诊为RA和非RA患者各120例,分为观察组和对照组。分别用电化学发光法测定抗CCP抗体浓度,免疫散射比浊法测定血清RF、hs-CRP的浓度,并对以上3项指标进行统计分析。结果:观察组抗CCP抗体、RF血清浓度水平明显高于对照组(P<0.05)。观察组的阳性率明显高于对照组(P<0.05)。在3项指标单独检测中,抗CCP抗体具有较高灵敏度和特异度(86.6%,95.3%);3项指标联合检测的特异度最高,达到99.1%,阳性预测值达97.5%,平行试验灵敏度显著提高到93.3%,阴性预测值为94.2%。(P<0.05)。结论:抗CCP抗体在RA诊断中灵敏度与特异度较高,有利于RA的早期诊断;3项指标联合检测可明显提高临床对RA诊断的准确性。
Objective: To investigate the value of combined detection of anti-cyclic citrullinated peptide (CCP) antibody, hs-CRP and rheumatoid factor (RF) in the early diagnosis of rheumatoid arthritis (RA). Methods: 120 patients with RA and non-RA diagnosed in our hospital from 2014 to 2015 were selected and divided into observation group and control group. The concentration of anti-CCP antibody was determined by electrochemiluminescence method. The concentrations of RF and hs-CRP were determined by immune nephelometry. Statistical analysis was made on the above three indexes. Results: The levels of anti-CCP antibody and RF serum in the observation group were significantly higher than those in the control group (P <0.05). The positive rate of the observation group was significantly higher than that of the control group (P <0.05). The anti-CCP antibody had higher sensitivity and specificity (86.6%, 95.3%) in the three independent tests. The combined detection of the three indexes had the highest specificity of 99.1% and the positive predictive value of 97.5%. The sensitivity of parallel assay Significantly increased to 93.3%, negative predictive value of 94.2%. (P <0.05). Conclusion: The anti-CCP antibody has higher sensitivity and specificity in the diagnosis of RA, which is beneficial to the early diagnosis of RA. Combined detection of three indexes can significantly improve the accuracy of clinical diagnosis of RA.