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目的:研究多标志物联合检测在类风湿关节炎诊断中的应用价值;方法:选择2014年7月—2015年6月在我院检查的RA患者158例,纳入实验组,选择同期在我院接受治疗的自身免疫性疾病患者110例及体检正常者190例纳入对照组,两组患者性别、年龄比较无统计学差异(P>0.05)。检测两组类风湿因子(RF)、角蛋白抗体(AKA)、葡萄糖-6-磷酸异构酶(GPI)、环瓜氨酸多肽抗体(抗-CCP);结果:标志物单项检测中,特异性最高为抗-CCP(90.65%),敏感性最高为RF(80.38%),阴性预测值最高为RF(88.26%),阳性预测值最高为抗-CCP(82.6%);标志物双项联合检测中,特异性最高为AKA+抗-CCP(94.61%),敏感性最高为抗-CCP+RF(67.72%),阴性预测值最高为RF+抗-CCP(84.89%),阳性预测值最高为AKA+抗-CCP(84.02%);标志物三项联合检测中,特异性最高为GPI+AKA+抗-CCP(95.02%),敏感性最高为GPI+RF+抗-CCP(63.92%),阴性预测值最高为RF+GPI+抗-CCP(82.02%),阳性预测值最高为CCP+RF+GPI(86.96%);标志物四项联合检测中,检测RA的特异性为96.74%,阴性预测值为80.74%,阳性预测值为88.74%;结论:多项标志物联合检测可准确诊断RA并判断预后,值得应用于临床。
OBJECTIVE: To study the value of combined detection of multiple markers in the diagnosis of rheumatoid arthritis.Methods: One hundred and eighty-eight RA patients examined in our hospital from July 2014 to June 2015 were selected and included in the experimental group. 110 cases of autoimmune diseases treated and 190 cases of normal control were included in the control group. There was no significant difference in gender and age between the two groups (P> 0.05). Two groups of rheumatoid factor (RF), keratin antibody (AKA), glucose-6-phosphate isomerase (GPI) and cyclic citrullinated peptide antibody (anti-CCP) were detected; Results: (90.65%), the highest sensitivity was RF (80.38%), the highest negative predictive value was RF (88.26%) and the highest positive predictive value was anti-CCP (82.6% The highest specificity was AKA + anti-CCP (94.61%), the highest sensitivity was anti-CCP + RF (67.72%), the highest negative predictive value was RF + anti-CCP (84.89%), and the highest positive predictive value was AKA + Anti-CCP (84.02%). Among the three combined tests, the highest specificity was GPI + AKA + anti-CCP (95.02%), the highest sensitivity was GPI + RF + anti-CCP (63.92%), and the highest negative predictive value RF + GPI + anti-CCP (82.02%), the highest positive predictive value was CCP + RF + GPI (86.96%). In the four combined tests, the specificity of detecting RA was 96.74% and the negative predictive value was 80.74% , And the positive predictive value was 88.74%. CONCLUSION: The combined detection of multiple markers can accurately diagnose RA and determine the prognosis, which is worthy of clinical application.