抗环瓜氨酸肽抗体对类风湿性关节炎早期诊断的应用研究.pdf

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1、·440·检验医学2011年7月第26卷第里L【0!!!!z!：：!文章编号：1673~640(2011)07-0440-04中图分类号：R446．62文献标志码：A抗环瓜氨酸肽抗体对类风湿性关节炎早期诊断的应用研究王玉俊，陈洁，万年红，顾军，顾国宝(上海市闸北区中心医院检验科，上海200070)摘要：目的探讨抗环瓜氨酸肽(CCP)抗体对类风湿性关节炎(RA)早期诊断的临床意义。方法应用酶联免疫吸附试验(ELISA)对126例病程<2年的RA患者、135例非RA患者、ll2名健康体检者进行抗CCP抗体的定量检测，并与类风湿因子(RF)相比较。结果抗CCP抗

2、体在RA组的阳性率为63．5％，明显高于非Pot患者组(2．2％)和健康对照组(0．0％)，抗CCP抗体的特异性(97．8％)显著高于RF(83．7％)，假阳性率(2．2％)显著低于RF(16．3％)(P均<0．001)；抗CCP抗体阳性RA患者的红细胞沉降率(ESR)和c反应蛋白(CRP)均显著高于抗CCP抗体阴性的RA患者。对抗CCP抗体阳性而RF阴性的RA患者追踪观察表明，半年后其中42．9％的患者RF转为阳性。结论抗CCP抗体对早期RA诊断有很高的特异性，具有反映RA病情是否活动和帮助判断预后的应用价值；由于血清抗CCP抗体可以较RF先出现，具有早

3、期诊断价值。关键词：抗环瓜氨酸肽抗体；类风湿性关节炎；类风湿因子；早期诊断；评价Applicationresearchofanti-cycliccitrullinatedpeptideantibodyintheearlydiagnosisofrheumatoidarthritisWANGYujun，CHENfie，WANNianhong，GUJan，GUGuobao．(DepartmentofClinicalLaboratory，ShanghaiZhabeiDistrictCentreHospital，Shanghai200070，China)Abstra

4、ct：ObjectiveToinvestigatetheclinicalsignificanceofanti—cycliceitrullinatedpeptide(CCP)antibodyintheearlydiagnosisofrheumatoidarthritis(RA)．MethodsAnti—CCPantibodyexpressionlevelsweredetectedbyenzyme-linkedimmunosorbentassay(ELISA)andcomparedwiththerheumatoidfactor(RF)expressionin1

5、26easesofRApatientswiththediseasecourse<2years．135casesofnon—RApatientsand112casesofhealthysubjects．ResultsThepositiverateofanti—CCPantibodyinRAgroupwas63．5％．andWassignificantlyhigherthanthoseinthenon—RAgroup(2．2％)andthehealthycontrolgroup(0．0％)．Thespecificityofanti—CCPantibody(97

6、．8％)washigherthanthatofRF(83．7％)，whilethefalsepositiverate(2．2％)wassignificantlylowerthanthatofRF(16．3％，P<0．001)．Erythrocytesedimentationrate(ESR)andCreactiveprotein(CRP)levelintheanti—CCPantibodypositivepatientsweresignificantlyhigherthanthoseintheanti—CCPantibodynegativeRApatien

7、ts．Thefollow—upresuhstotheanti-CCPantibodypositiveandRFnegativepatientsdemonstratedthatRFturnedtobepositivein42．9％patientsafterahalfyear．ConclusionsAnti—CCPantibodyishighlyspecificintheearlydiagnosisofRA，andcallreflectthediseaseprogressionandhelptheprognosisprediction．Becausethean

8、ti—CCPantibodyappeamearlierthanRF