107例类风湿关节炎患者血清自身抗体分析(1)
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[摘要] 目的 探讨类风湿关节炎(RA)患者血清类风湿因子(RF)、抗角蛋白抗体(AKA)、抗核抗体(ANA)、抗环瓜氨酸肽抗体(CCP)的阳性率及其临床意义。 方法 对107例RA患者(RA组)、61例OA患者(OA组)和32例健康对照(对照组)进行RF、AKA、ANA、CCP 抗体检测，其中RF 采用胶乳凝集法检测，CCP采用酶联免疫吸附法(ELISA)检测，AKA和ANA采用间接免疫荧光法(ⅡF)法检测。 结果 RF、AKA、ANA、CCP 在RA组的敏感性和特异性分别为75.7%和84.9%、34.6%和96.8%、11.2%和94.6%、84.1%和96.8%，RF、AKA、CCP阳性率显著高于OA组和对照组。 结论 四种抗体中，抗CCP抗体对RA的诊断价值较高。 RF、ANA因特异性较低和AKA因敏感性差，对RA的诊断作用受到影响。自身抗体的检测有利于RA早期诊断和鉴别诊断。
[关键词] 类风湿关节炎；自身抗体；抗环瓜氨酸肽抗体
[中图分类号] R593.22 [文献标识码] B [文章编号] 1673-9701(2012)01-090-02
Analysis on serum autoantibodies of 107 patients with rheumatoid arthritis
LI Penghua WANG Guiqin
Department of Kidney Disease and Rheumatology, Shanxi Medical University Fenyang Hospital, Fenyang 032200, China
[Abstract] Objective To investigate the positive rates and clinic significance of rheumatoid arthritis (RA, , rheumatoid factor (RF), anti-keratin antibodies (AKA), anti-nuclear antibody (ANA), as well as anti-cyclic citrullinated peptide antibodies (CCP). Methods All 107 patients with RA (group RA), 61 patients with OA (group OA) and 32 healthy people (control group) were tested on their antibodies of RF, AKA, ANA and CCP. Among them the latex agglutination testing method was used in RF, enzyme-linked immunosorbent assay (ELISA) in CCP, indirect immunofluorescence assay (ⅡF) in AKA and ANA. Results The sensitivity and specificity of RF, AKA, ANA and CCP in group RA are respectively (75.7%, 84.9%), (34.6%, 96.8%), (11.2%, 94.6%), (84.1%, 96.8%). The positive rates of RF, AKA and CCP aresignificantly were higher than group OA and control group. Conclusion The anti-CCP antibody for the diagnosis of RA is of higher value in four kinds of antibodies. The diagnosis function of RA may be affected due to low specificity of RF and ANA, and poor sensitivity of AKA. The antibodies test is good for early diagnosis of RA and differential diagnosis.
[Key words] Rheumatoid arthritis；Autoantibodies；Anti-cyclic citrullinated peptide antibodies
类风湿关节炎(RA)是一种以对称性多关节炎为主要临床表现、滑膜炎为病理改变的系统性、自身免疫性疾病，可导致关节和关节周围结构进行性破坏，是我国人群丧失劳动力和致残的主要原因之一。临床上骨关节炎(OA)与RA有时难以鉴别，尤其是早期不典型的RA易造成误诊或漏诊，因此寻求灵敏度好、特异性高的指标用于RA的早期诊断已成为国内外学者一个新的研究方向。2000年曾小峰等发现抗CCP 抗体是诊断RA的一项良好的血清学指标 ......
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