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目的探讨抗角蛋白抗体(AKA)、抗环胍氨酸肽抗体(抗CCP)和类风湿因子(RF)联合检测对类风湿性关节炎(RA)的诊断价值。方法收集自2006年12月至2011年12月期间在我院检查的RA患者120例,其他自身免疫病患者120例和健康对照者120例的血清,分别采用间接免疫荧光法、酶联免疫吸附试验(ELISA)和颗粒增强速率散射比浊法检测AKA、抗CCP和RF,比较3种抗体单独和联合检测对诊断RA的敏感性和特异性。结果类风湿性关节炎患者三种抗体的阳性率均高于其他自身免疫病患者和健康对照者(P<0.05)。抗CCP的敏感性、阳性预测值、阴性预测值均比其他两种抗体高、AKA的特异性最好。三种抗体联合检测诊断RA的敏感度可达84.17%,比单独检测单一抗体的敏感性都高。结论联合检测AKA、抗CCP及RF对于RA的诊断和早期诊断具有重要的应用价值。
Objective To investigate the diagnostic value of anti-keratin antibody (AKA), anti-cyclic citrulline peptide antibody (anti-CCP) and rheumatoid factor (RF) in the diagnosis of rheumatoid arthritis (RA). Methods Serum from 120 patients with RA, 120 patients with other autoimmune diseases and 120 healthy controls were collected from our hospital from December 2006 to December 2011. The serums of 120 patients with RA were detected by indirect immunofluorescence, enzyme-linked immunosorbent assay The sensitivity and specificity of three kinds of antibodies for the diagnosis of RA were tested by ELISA and particle size contrast nephelometry (AKI), anti-CCP and RF. Results The positive rates of three kinds of antibodies in patients with rheumatoid arthritis were higher than those in other autoimmune diseases and healthy controls (P <0.05). Anti-CCP sensitivity, positive predictive value, negative predictive value were higher than the other two antibodies, AKA best specificity. The sensitivity of the combined detection of three antibodies to diagnosis of RA was up to 84.17%, which was higher than the sensitivity of single antibody detection alone. Conclusions The combined detection of AKA, anti-CCP and RF has important value in the diagnosis and early diagnosis of RA.