红细胞沉降率、抗环瓜氨酸肽抗体、类风湿因子以及C反应蛋白在早期类风湿性关节炎诊治中的意义

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英文篇名：The Significance of Erythrocyte Sedimentation Rate, Anti-Cyclic Citrullinated Peptide Antibody, Rheumatoid Factor and C-Reactive Protein in Early Rheumatoid Arthritis 作者：李俊娥 ; 韩公海 ; 潘宝龙 ; 矣玲萍 英文作者：Li June;Han Gonghai;Pan Baolong;Yi Lingping;Clinical Laboratory, The Sixth Affiliated Hospital of Kunming Medical University;Kunming Medical University;Chuxiong Medical College; 关键词：类风湿因子 ; 类风湿性关节炎 ; C反应蛋白 ; 抗环瓜氨酸肽抗体 ; 红细胞沉降率 英文关键词：Rheumatoid factor;;Rheumatoid arthritis;;C-reactive protein;;Anti-cyclic citrullinated peptide antibody;;Erythrocyte sedimentation rate 中文刊名：YLZB 英文刊名：Medical Equipment 机构：昆明医科大学第六附属医院检验科;昆明医科大学;楚雄医药高等专科学校; 出版日期：2018-05-15 出版单位：医疗装备 年：2018 期：v.31;No.358 基金：云南省高层次卫生技术人才专项经费资助项目(编号D-201206) 语种：中文; 页：YLZB201809003 页数：3 CN：09 ISSN：11-2217/R 分类号：12-14

摘要

目的评价类风湿性关节炎(RA)血清学指标红细胞沉降率(ESR)、抗环瓜氨酸肽(CCP)抗体、类风湿因子(RF)以及C反应蛋白(CRP)在RA诊治中的意义。方法选取130例早期RA患者作为早期RA组,120例其他自身免疫性疾病患者作为非RA组,90名健康体检者作为对照组。运用速率散射比浊法、自然沉降法、免疫比浊法检测血清ESR、抗CCP抗体、RF以及CRP水平,并分析4种检测指标在RA中的价值。结果早期RA组血清ESR、抗CCP抗体、RF和CRP水平及阳性检出率明显高于对照组及非RA组,差异均有统计学意义(P<0.05);单独检测RA的灵敏度依次为RF>CCP>ESR>CRP,特异度依次为CCP>RF>CRP>ESR;4项血清学指标分别以不同方式联合检测诊断RA,灵敏度提高,特异度下降。结论在RA患者的诊治中,血清ESR、抗CCP抗体、RF以及CRP存在一定的价值,且联合检测提高了RA的早期诊断率。
        Objective To study the significance of rheumatoid factor(RF), anti-cyclic citrullinated peptide(CCP) antibody, C-reactive protein(CRP) and erythrocyte sedimentation rate(ESR) in early rheumatoid arthritis(RA). Methods Set up three groups; serum samples were collected from 130 early period RA patients, 120 non-RA patients(patients with other autoimmune diseases) and 90 healthy controls. Used rate scattering turbidimetry, natural sedimentation method, and immune turbidimetric method to detect the serum ESR, anti-CCP antibody, RF and CRP levels of all subjects, and did the statistical analysis of four detection indicators in the value of RA. Results Serum ESR, anti-CCP antibody, RF and CRP levels and positive detection rate in the early RA group were significantly higher than those in the control group and nonRA group, and the differences were statistically significant(P<0.05). The sort of sensitivity to RA was RF>CCP>ESR>CRP, and the sort of specificity was CCP>RF>CRP>ESR; Four serological indexes respectively joint detection in the diagnosis of RA in different ways, showed increased sensitivity and decreased specificity. Conclusion In the diagnosis and treatment of RA, ESR, anti-CCP antibody, RF and serum CRP have certain value, and the joint detection can improve the early diagnostic rate of RA.

引文

[1]何思华,陈明舜,卢绍佳,等.抗环瓜氨酸抗体和类风湿因子联合测定在61例类风湿关节炎诊断的临床应用[J].检验医学与临床,2014,11(2):217-219.
    [2]王银山.类风湿性关节炎的研究进展[J].中国现代医药杂志,2008,10(10):131-134.
    [3]王霞,谷磊,张迎梅,等.抗CCP抗体与RF联合检测诊断类风湿性关节炎的临床价值[J].现代诊断与治疗,2014,25(15):3517-3518.
    [4]彭萍.GPI、抗CCP、AKA、APF抗体与RF联合检测在类风湿关节炎早期诊断中的应用研究[D].长沙:中南大学,2014.
    [5]耿学丽,张秀琴,陈向华,等.类风湿性关节炎患者类风湿因子抗环瓜氨酸抗体抗角蛋白抗体联合检测的临床意义[J].河北医学,2015,21(5):736-739.
    [6]封昱辰,房晴晴,蔺军平,等.葡萄糖-6-磷酸异构酶、抗环瓜氨酸肽抗体、类风湿因子联合检测对类风湿关节炎的诊断价值[J].检验医学,2016,31(7):567-570.
    [7]Schellekens GA,Visser H,De Jong BA,et al.The diagnostic properties of rheumatoid arthritis antibodies recognizing a cyclic citrullinated peptide[J].Arthritis Rheum,2000,43(1):155-163.
    [8]杨沙,杨族.血清抗环瓜氨酸抗体检测在类风湿性关节炎诊断中的应用[J].云南医药,2015,36(6):640-641.
    [9]邹长进,许海兵,郑迎春.抗环瓜氨酸肽抗体定量检测在类风湿性关节炎诊断中的临床应用[J].中国卫生检验杂志,2015,25(11):1786-1787,1790.
    [10]代群,潘顺文,陈亚琼,等.联合检测血清抗-CCP、AKA及RF对类风湿性关节炎的诊断价值[J].中国卫生检验杂志,2015,25(15):2548-2549,2552.
    [11]杨永昌,张淑艳,贾志凌,等.抗CCP抗体、类风湿因子及C反应蛋白在类风湿性关节炎诊断中的应用评价[J].国际检验医学杂志,2014,35(6):781-783.
    [12]董旭才,沈建军,张婧,等.类风湿因子、抗环瓜氨酸肽抗体和ESR联合检测在类风湿性关节炎的临床意义[J].国际检验医学杂志,2014,35(16):2260,2273.
    [13]张伶俐,连军,周亮.类风湿关节炎患者hs-CRP、ESR及RF的临床应用[J].中国农村卫生,2014(10):46-47.
    [14]王婷,何燕霞.AKA、CCP、RA33、RF联合检测对类风湿关节炎的临床诊断价值[J].中国现代医生,2015,53(20):96-98,102.
    [15]胡凯,袁光勇,邓文,等.自身抗体检测在类风湿关节炎的临床诊断价值评价[J].实验与检验医学,2015,33(1):108-111.
    [16]Chang PY,Yang CT,Cheng CH,et al.Diagnostic performance of anticyclic citrullinated peptide and rheumatoid factor in patients with rheumatoid arthritis[J].Int J Rheum Dis,2015,19(9):880-886.