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目的探讨血清葡萄糖-6-磷酸异构酶(GPI)、抗环瓜氨酸肽抗体(anti-CCP)、抗突变型瓜氨酸波形蛋白抗体(anti-MCV)、类风湿因子(RF)对类风湿性关节炎(RA)的诊断价值。方法设置RA组、其他自免病组、健康对照组,检测单个指标在三组中的血清学水平;做单项检测RA的性能评价;以逐步Logistic回归结果的ROC曲线下面积(AUC)比较分析4个指标单独及联合检测的特异度;总结RA组4个指标的互补关系。结果 (1)单项指标在三组受试对象水平差异有统计学意义(P<0.05),RA组与其他自免组和健康对照组两两比较差异有统计学意义(P<0.05);(2)单个指标检测RA患者性能评价,总符合率为:GPI>抗MCV>抗CCP>RF,但差异无统计学意义;(3)4项指标联合检测时用Logistic回归法模拟的AUC大于单独检测的AUC;(4)单一指标阴性时,其他3个指标均有一定的阳性率。结论 GPI,抗CCP,抗MCV,RF是诊断RA的标志性指标,各指标对RA诊断价值比较还有待进一步验证,但联合检测可提高RA诊断的灵敏度和特异度,尤其是对临床症状不典型或RF阴性者,有利于RA的早期诊断和治疗。
Objective To investigate the effects of serum glucose-6-phosphate isomerase (GPI), anti-CCP, anti-MCV and rheumatoid factor (RF) Rheumatoid arthritis (RA) diagnostic value. Methods Serum levels of RA, other self-harm-free group and healthy control group were measured and the single index was used to evaluate the performance of RA. The area under the ROC curve (AUC) was analyzed by stepwise Logistic regression The specificity of 4 indexes alone and in combination test was summarized. The complementation of 4 indexes in RA group was summarized. Results (1) There was significant difference between the three groups (P <0.05). There was significant difference between the RA group and other groups (P <0.05) and the healthy control group (P <0.05) 2) The performance of single index in evaluating RA patients showed that the overall coincidence rate was GPI> anti-MCV> anti-CCP> RF, but the difference was not statistically significant. (3) Logistic regression showed that the AUC Test AUC; (4) a single negative, the other three indicators have a certain positive rate. Conclusion GPI, anti-CCP, anti-MCV, and RF are the hallmarks of diagnosis of RA. The comparison of the diagnostic value of each index with RA remains to be further verified, but the combined detection can improve the sensitivity and specificity of RA diagnosis, especially for atypical clinical symptoms Or RF-negative, is conducive to the early diagnosis and treatment of RA.