抗突变型瓜氨酸波形蛋白抗体对类风湿关节炎的诊断价值
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摘要
目的:探讨抗突变型瓜氨酸波形蛋白抗体(抗MCV)对类风湿关节(rheumatoid arthritis,RA)的诊断价值。方法:收集79例RA患者、51例非RA自身免疫性疾病患者和40名健康体检者血清;采用全自动酶联免疫法定量检测抗MCV、RF IgG、RF IgA,化学发光法检测抗CCP,速率散射比浊法检测RF IgM,并对结果进行分析。结果:RA组患者血清中抗MCV含量为(451.07±40.38)IU/mL,明显高于非RA自身免疫性疾病组和正常对照组(P<0.01)。ROC曲线确定抗MCV诊断RA的最佳阈值为54.05 IU/mL;其ROC曲线下面积为0.940,较RF IgM、RF IgG、RF IgA明显增加(P<0.05),但与抗CCP比较差异无统计学意义。抗MCV诊断RA的灵敏度和特异性分别为89.87%、91.21%,高于其他4项指标;在抗MCV与其他指标联合检测中,抗MCV/抗CCP/RF IgM/RF IgG/RF IgA联合检测诊断RA的敏感性最高,为98.73%;而特异性和准确性最高的是抗MCV/抗CCP联合检测,分别为90.11%、91.18%。在RA患者中,抗MCV与抗CCP、RF IgM、RF IgG、RF IgA有相关性,其相关系数分别为0.430、0.272、0.269、0.343(P<0.05)。结论:检测血清中抗MCV水平对于筛查和辅助诊断RA具有重要意义。
Objective:To explore the clinical value of anti-mutated citrullinated vimentin(anti-MCV) in rheumatoid arthritis(RA).Methods: The serum samples of 79 patients with RA,51 patients with other autoimmune diseases and 40 healthy controls were collected.The level of anti-MCV,RF IgG,and RF IgA were measured by Automatic enzyme-linked immunoassay.The level of anti-CCP and RF IgM were detected by chemoluminescence assay(CIMA) and Turbidimetric assay respectively,and the results were analyzed.Results:The serum level of anti-MCV in RA was 451.07±40.38 IU/mL,which was significantly higher than the AID group and the normal control group(P<0.01).The optimal threshold of anti-MCV was 54.05 IU/mL according to ROC curve,and the AUC of anti-MCV was 0.940,which was significantly higher than RF IgM,RF IgG,and RF IgA(P<0.05).However,there was no difference between anti-MCV and anti-CCP.The sensitivity and specificity of Anti-MCV were 89.87% and 91.21% respectively,which was significantly higher than the other four indexes.Among the combined detection of anti-MCV and other indicators,the combined detection of anti-MCV/anti-CCP/RF IgM/RF IgG/RF IgA had the highest sensitivity in the diagnosis of RA,which was 98.73%.Anti-MCV presented a significantly positive correlation with anti-CCP,RF IgM,RF IgG and RF IgA.The correlation coefficient were 0.430,0.272,0.269 and 0.343 respectively(P<0.05).Conclusion:Serum level of anti-MCV has an important significance in screening and diagnosis of RA is important.
Objective:To explore the clinical value of anti-mutated citrullinated vimentin(anti-MCV) in rheumatoid arthritis(RA).Methods: The serum samples of 79 patients with RA,51 patients with other autoimmune diseases and 40 healthy controls were collected.The level of anti-MCV,RF IgG,and RF IgA were measured by Automatic enzyme-linked immunoassay.The level of anti-CCP and RF IgM were detected by chemoluminescence assay(CIMA) and Turbidimetric assay respectively,and the results were analyzed.Results:The serum level of anti-MCV in RA was 451.07±40.38 IU/mL,which was significantly higher than the AID group and the normal control group(P<0.01).The optimal threshold of anti-MCV was 54.05 IU/mL according to ROC curve,and the AUC of anti-MCV was 0.940,which was significantly higher than RF IgM,RF IgG,and RF IgA(P<0.05).However,there was no difference between anti-MCV and anti-CCP.The sensitivity and specificity of Anti-MCV were 89.87% and 91.21% respectively,which was significantly higher than the other four indexes.Among the combined detection of anti-MCV and other indicators,the combined detection of anti-MCV/anti-CCP/RF IgM/RF IgG/RF IgA had the highest sensitivity in the diagnosis of RA,which was 98.73%.Anti-MCV presented a significantly positive correlation with anti-CCP,RF IgM,RF IgG and RF IgA.The correlation coefficient were 0.430,0.272,0.269 and 0.343 respectively(P<0.05).Conclusion:Serum level of anti-MCV has an important significance in screening and diagnosis of RA is important.
引文
[1] Uutela TI,Kautiainen HJ,Hakkinen AH.Decreasing muscle performance associated with increasing disease activity in patients with rheumatoid arthritis [J].PLoS One,2018,13(4):e0194917.
[2] 关蕊,张杰.抵抗素在类风湿关节炎中的作用[J].川北医学院学报,2017,32(6):956-959.
[3] Nordberg LB,Lillegraven S,Aga AB,et al.Comparing the disease course of patients with seronegative and seropositive rhrumatoid arthritis fulfilling the 2010 ACR/EULAR classification criteria in a treat-to-target setting:2-year data from the ARCTIC trial [J].RMD Open,2018,4(2):e000752
[4] 李宝贞,莫汉有,石宇红,等.修订分类标准诊断血清学阴性与阳性类风湿关节炎临床特征的比较[J].东南大学学报(医学版),2016,35(5):664-669.
[5] Gavrila BI,Ciofu C,Stoica V.Biomarkers in Rheumatoid Arthritis,what is new?[J].J Med Life,2016,9(2):144-152.
[6] Martínez Téllez G,Torres Rives B,Gómez Morejon JA,et al.Diagnostic value of anti-fibrinogen citrullinated peptide in Rheumatoid Arthritis[J].Reumatol Clin,2018,18:30258-30262.
[7] Sokolove J,Johnson DS,Lahey LJ,et al.Rheumatoid factor as a potentiator of anti-citrullinated protein antibody-mediated inflammation in rheumatoid arthritis [J].Arthritis Rheumatol,2014,66(4):813-821.
[8] 叶霖,王友莲.类风湿关节炎的中西医发病机制综述[J].江西医药,2017,52(1):88-91.
[9] Harnden K,Pease C,Jackson A.Rheumatoid arthritis[J].BMJ,2016,352:1387.
[10] Porto LS,Tavares WC Júnior,Costa DA,et al.Anti-CCP antibodies are not a marker of severity in established rheumatoid arthritis:a magnetic resonance imaging study[J].Rev Bras Reumatol Engl Ed,2017,57 (1) :15-22.
[11] Ledingham JM.Importance of early detection and referral of rheumatoid arthritis[J].BMJ,2016,353:2172-2180.
[12] Barouta G,Katsiari CG,Alexiou I,et al.Anti-MCV antibodies predict radiographic progression in Greek patients with very early (<3 months duration) rheumatoid arthritis[J].Clin Rheumatol,2017,36(4):885-894.
[13] Safi MA,Attar SM,Fathaldin OA,et al.Anti-mutated citrullinated vimentin antibody and rheumatoid factor (prevalence and association) in rheumatoid arthritis patients;Saudi and non-Saudi[J].Clin Lab,2015,61(3-4):259-267.
[14] 何东仪,程鹏,聂红,等.突变型瓜氨酸波形蛋白抗体在类风湿关节炎诊断中的意义[J].现代免疫学,2010,30(4):318-323.
[2] 关蕊,张杰.抵抗素在类风湿关节炎中的作用[J].川北医学院学报,2017,32(6):956-959.
[3] Nordberg LB,Lillegraven S,Aga AB,et al.Comparing the disease course of patients with seronegative and seropositive rhrumatoid arthritis fulfilling the 2010 ACR/EULAR classification criteria in a treat-to-target setting:2-year data from the ARCTIC trial [J].RMD Open,2018,4(2):e000752
[4] 李宝贞,莫汉有,石宇红,等.修订分类标准诊断血清学阴性与阳性类风湿关节炎临床特征的比较[J].东南大学学报(医学版),2016,35(5):664-669.
[5] Gavrila BI,Ciofu C,Stoica V.Biomarkers in Rheumatoid Arthritis,what is new?[J].J Med Life,2016,9(2):144-152.
[6] Martínez Téllez G,Torres Rives B,Gómez Morejon JA,et al.Diagnostic value of anti-fibrinogen citrullinated peptide in Rheumatoid Arthritis[J].Reumatol Clin,2018,18:30258-30262.
[7] Sokolove J,Johnson DS,Lahey LJ,et al.Rheumatoid factor as a potentiator of anti-citrullinated protein antibody-mediated inflammation in rheumatoid arthritis [J].Arthritis Rheumatol,2014,66(4):813-821.
[8] 叶霖,王友莲.类风湿关节炎的中西医发病机制综述[J].江西医药,2017,52(1):88-91.
[9] Harnden K,Pease C,Jackson A.Rheumatoid arthritis[J].BMJ,2016,352:1387.
[10] Porto LS,Tavares WC Júnior,Costa DA,et al.Anti-CCP antibodies are not a marker of severity in established rheumatoid arthritis:a magnetic resonance imaging study[J].Rev Bras Reumatol Engl Ed,2017,57 (1) :15-22.
[11] Ledingham JM.Importance of early detection and referral of rheumatoid arthritis[J].BMJ,2016,353:2172-2180.
[12] Barouta G,Katsiari CG,Alexiou I,et al.Anti-MCV antibodies predict radiographic progression in Greek patients with very early (<3 months duration) rheumatoid arthritis[J].Clin Rheumatol,2017,36(4):885-894.
[13] Safi MA,Attar SM,Fathaldin OA,et al.Anti-mutated citrullinated vimentin antibody and rheumatoid factor (prevalence and association) in rheumatoid arthritis patients;Saudi and non-Saudi[J].Clin Lab,2015,61(3-4):259-267.
[14] 何东仪,程鹏,聂红,等.突变型瓜氨酸波形蛋白抗体在类风湿关节炎诊断中的意义[J].现代免疫学,2010,30(4):318-323.