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目的:1检测类风湿关节炎(RA)病人血清抗聚角蛋白微丝蛋白抗体(AFA)、抗环瓜氨酸肽(CCP)抗体及类风湿因子(RF),比较单独检测和联合检测对RA诊断的敏感性、特异性、阳性预测值。2比较AFA、抗CCP抗体阳性组与阴性组间关节指数、晨僵时间、血沉(ESR)、C反应蛋白(CRP)、X线骨侵蚀之间的关系。3分析引起骨侵蚀的危险因素。方法:RA组92例血清标本来自2003-10~2005-01就诊于内蒙古医学院附属医院内科门诊及住院病人。AFA、抗CCP抗体用酶联免疫吸附法(ELISA),RF、CRP用液相终点散射沉淀法。结果:1AFA、抗CCP抗体阳性率与对照组有统计学意义(P<0.05)。2AFA、抗CCP抗体、RF联合检测的敏感性降低,特异性、阳性预测值较单独检测明显升高(P<0.05)。3AFA、抗CCP抗体阳性组病情活动指标与阴性对照组差异有统计学意义(P<0.05),抗CCP抗体阳性是RA发生骨侵蚀的危险因素之一。结论:抗CCP抗体、AFA有共同的抗原决定簇,存在相关性,但不完全重叠。临床上与RF联合检测有助于提高RA的早期诊断、预测病情的活动性及严重程度,具有广泛的临床应用前景。
Objective: To detect serum anti-keratin fibroin antibody (AFA), anti-cyclic citrullinated peptide (CCP) antibody and rheumatoid factor (RF) in patients with rheumatoid arthritis (RA) RA diagnostic sensitivity, specificity, positive predictive value. 2 Compare the relationship between AFA, anti-CCP antibody positive group and negative group of joint index, morning stiffness time, ESR, CRP and X-ray erosion. 3 Analysis of the risk factors for bone erosion. Methods: The serum samples from 92 patients in RA group came from outpatient and inpatient department of Inner Mongolia Medical College Affiliated Hospital from 2003-10 to 2005-01. AFA, anti-CCP antibody by enzyme-linked immunosorbent assay (ELISA), RF, CRP by liquid phase endpoint scattering precipitation method. Results: The positive rate of 1AFA and anti-CCP antibody was significantly higher than that of the control group (P <0.05). The sensitivity, specificity and positive predictive value of 2AFA, anti-CCP antibody and RF combined detection were significantly higher than those of single detection (P <0.05). The activity of 3AFA and anti-CCP antibody positive group was significantly different from that of negative control group (P <0.05). Anti-CCP antibody positive was one of the risk factors of bone erosion. Conclusion: Anti-CCP antibodies, AFA have common epitopes, there is correlation, but not completely overlap. Clinically combined with RF test can help improve the early diagnosis of RA, predict the activity and severity of the disease, with a wide range of clinical applications.