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目的探讨抗纤聚蛋白抗体(AFA)在类风湿关节炎(RA)中的意义,并比较AFA与类风湿因子(RF)、抗角蛋白抗体(AKA)、抗核周因子(APF)和抗环瓜氨酸肽(CCP)抗体以及某些临床指标的相关性。方法对860例研究对象,包括388例RA患者(其中早期172例,中晚期216例),422例非RA的风湿性疾病患者,50名健康对照,用免疫印迹法(IB)检测血清中的AFA。同时检测其他RA相关自身抗体。结果AFA在早期RA病例中阳性率为62.2%,在中晚期RA病例中阳性率为58.8%,对RA诊断敏感性60.3%,特异性91.1%,阳性和阴性预测值分别为94.6%、68.0%。AFA和AKA在早期和中晚期RA的阳性率差异无统计学意义,而RF、APF和抗CCP抗体在中晚期组的阳性率大于早期组。AFA与RF、AKA、APF以及抗CCP抗体相关(P<0.05)。AFA与RA患者平均发病年龄相关(P=0.047)。结论AFA可视为RA的特异性血清学标记,尤其对RF阴性及早期RA诊断很有帮助;AFA与其他RA相关自身抗体相关,联合检测可以相互补充,提高对RA的诊断。
Objective To investigate the significance of anti-fibronectin antibody (AFA) in rheumatoid arthritis (RA) and to compare the effects of AFA with rheumatoid factor (RF), anti-keratin antibody (AKA), anti-nuclear factor (APF) Cyclic citrullinated peptide (CCP) antibodies and some clinical indicators. Methods A total of 860 subjects, including 388 RA patients (172 in the early stage and 216 in the advanced stage), 422 rheumatic diseases without RA, and 50 healthy controls, were used to detect the serum levels of AFA. At the same time detect other RA-related autoantibodies. Results The positive rate of AFA was 62.2% in early RA patients, 58.8% in RA patients, 60.3% in RA patients, and 91.1% in RA patients. The positive and negative predictive values of AFA were 94.6% and 68.0% . There was no significant difference in the positive rates of AFA and AKA between early and middle RA patients, while the positive rates of RF, APF and anti-CCP antibody in the advanced and advanced patients were higher than those in the early patients. AFA was associated with RF, AKA, APF, and anti-CCP antibodies (P <0.05). The average age at onset of AFA was associated with RA (P = 0.047). Conclusion AFA can be regarded as a specific serological marker of RA, especially for the diagnosis of RF-negative and early RA. AFA is associated with other RA-related autoantibodies, and the combined detection can complement each other and improve the diagnosis of RA.