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目的探讨抗环瓜氨酸多肽(cyclic citrullinated peptide,CCP)抗体与类风湿因子(rheumatoid factor,RF)单独及联合诊断类风湿性关节炎(rheumatoid arthritis,RA)价值。方法 RA患者38例(RA组),非RA自身免疫性疾病患者32例(非RA自免组),炎症患者34例(炎症组),同期体检健康者38名(对照组),分别应用ELISA法和免疫透射比浊法检测4组血清抗CCP抗体和RF水平比较4组抗CCP抗体和RF水平及阳性率,分析抗CCP抗体单独及与RF联合早期诊断RA的价值。结果 RA组抗CCP抗体水平、抗CCP抗体及RF阳性率均高于非RA自免组、炎症组、对照组(P<0.01);RA组RF阳性率高于抗CCP抗体阳性率,但差异无统计学意义(P>0.05);抗CCP抗体诊断RA特异度(94.23%)高于RF(67.30%)(P<0.01);抗CCP抗体与RF联合诊断RA的特异度、阳性预测值、总符合率、Youden指数均高于2项指标单独检测(P<0.01)。结论抗CCP抗体具有较高敏感度和特异度,与RF联合检测可提高RA诊断准确性。
Objective To investigate the value of cyclic citrullinated peptide (CCP) antibody combined with rheumatoid factor (RF) in the diagnosis of rheumatoid arthritis (RA). Methods Thirty-eight RA patients (RA group), 32 non-RA autoimmune diseases (non-RA patients), 34 inflamed patients (inflammation group) and 38 healthy volunteers (control group) Anti-CCP antibody and RF level in four groups were detected by immunoturbidimetry and immunofluorescence turbidimetry. The anti-CCP antibody, RF level and positive rate were compared among the four groups. The value of anti-CCP antibody alone and combined with RF in the early diagnosis of RA was analyzed. Results The level of anti-CCP antibody, anti-CCP antibody and RF positive rate in RA group were higher than that in non-RA autoimmune group, inflammatory group and control group (P <0.01). The positive rate of RF in RA group was higher than that of anti-CCP antibody, The specificity and positive predictive value of anti-CCP antibody combined with RF in the diagnosis of RA were higher than that of RF (67.30%) (P <0.01) Total coincidence rate, Youden index were higher than the two indicators were tested separately (P <0.01). Conclusion Anti-CCP antibody has high sensitivity and specificity, and combined with RF can improve the diagnostic accuracy of RA.