免疫比浊法测定抗环瓜氨酸肽抗体的临床应用研究
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摘要
目的研究免疫比浊法(LATEX)测定抗环瓜氨酸肽抗体(Anti-CCP)对类风湿关节炎(RA)的临床诊断价值。方法选择2016年9月～2018年4月于我院就诊的疑似RA患者182例为研究对象,采集所有人员血清,分别采用LATEX和酶联免疫吸附法(ELISA)检测Anti-CCP水平,并比较结果。结果 LATEX对RA诊断准确率为93.96%(171/182),与金标准结果一致性较好(Kappa=0.837),灵敏度为98.50%,特异度为81.25%,阳性预测值93.62%;ELISA对RA诊断准确率为91.21%(166/182),与金标准结果一致性较好(Kappa=0.761),灵敏度为97.01%,特异度为75.00%,阳性预测值91.55%;LATEX检测高水平总变异系数(2.01%)低于ELISA法总变异系数(2.51%); LATEX检测低水平总变异系数(2.11%)低于ELISA法总变异系数(2.66%)。结论 LATEX检测Anti-CCP准确率高,敏感度和特异度好,有利于RA早期诊断。
Objective To study the clinical diagnostic value of Anti-CCP determined by LATEX in RA.Methods 182 patients with suspected RA treated in our hospital from September 2016 to April 2018 were selected as the objects,and serum of all patients were collected.LATEX and ELISA were used to detect the level of Anti-CCP.The levels of Anti-CCP were detected by LATEX and enzyme linked immunosorbent assay(ELISA),respectively,and the results were compared. Results LATEX's diagnostic accuracy of RA was93.96%(171/182),which was consistent with the gold standard(Kappa=0.837),with a sensitivity of 98.50%,a specificity of 81.25% and a positive predictive value of 93.62%.ELISA's diagnostic accuracy of RA was 91.21%(166/182),which was consistent with the gold standard(Kappa=0.761),with a sensitivity of 97.01%,a specificity of 75.00% and a positive predictive value of 91.55%.LATEX detection of high level total variation coefficient(2.01%) and low level total variation coefficient(2.11%) were lower than ELISA of 2.51% and 2.66%,respectively.Conclusion LATEX detection of Anti-CCP has high accuracy and good sensitivity and specificity,which is beneficial to early diagnosis of RA.
Objective To study the clinical diagnostic value of Anti-CCP determined by LATEX in RA.Methods 182 patients with suspected RA treated in our hospital from September 2016 to April 2018 were selected as the objects,and serum of all patients were collected.LATEX and ELISA were used to detect the level of Anti-CCP.The levels of Anti-CCP were detected by LATEX and enzyme linked immunosorbent assay(ELISA),respectively,and the results were compared. Results LATEX's diagnostic accuracy of RA was93.96%(171/182),which was consistent with the gold standard(Kappa=0.837),with a sensitivity of 98.50%,a specificity of 81.25% and a positive predictive value of 93.62%.ELISA's diagnostic accuracy of RA was 91.21%(166/182),which was consistent with the gold standard(Kappa=0.761),with a sensitivity of 97.01%,a specificity of 75.00% and a positive predictive value of 91.55%.LATEX detection of high level total variation coefficient(2.01%) and low level total variation coefficient(2.11%) were lower than ELISA of 2.51% and 2.66%,respectively.Conclusion LATEX detection of Anti-CCP has high accuracy and good sensitivity and specificity,which is beneficial to early diagnosis of RA.
引文
[1]蔡晓菡,杨舒萍,陈宏浦,等.超声在类风湿关节炎中的应用[J].中国医学影像学杂志,2016,24(6):471-473.
[2]段京明,王瑞明,李祥双,等.细胞因子白细胞介素-6及胰岛素生长样因子-1与类风湿关节炎临床表现的关联性研究[J].中国骨质疏松杂志,2016,22(5):560-562.
[3]王斌,陈竹,李向培,等.少关节起病类风湿关节炎的临床分析[J].中华疾病控制杂志,2017,21(9):935-938.
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[6]戴婉如,周欢,林燕辉,等.免疫透射比浊法在AU5800全自动生化分析仪检测降钙素原的方法学评价[J].检验医学与临床,2015,12(10):1447-1448.
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[10]张静思,陈鑫苹,陈斌.RF、抗-CCP、AKA及GPI联合检测在类风湿关节炎诊断中的价值[J].重庆医学,2015,44(13):1788-1789.
[11]张文兰,胡同平,王永福,等.抗环瓜氨酸肽抗体对类风湿关节炎的诊断、治疗及预后的临床价值[J].中国免疫学杂志,2015,1541(11):1541-1544.
[12]杨梅花,王向红,冯忠军,等.类风湿性关节炎患者血浆Ghrelin水平变化及其与血清CRP、RF、抗-CCP的关系[J].山东医药,2015,55(33):18-20.
[13]关晓东,吴宇芳,陈少莹,等.联合检测ICTP、抗CCP抗体和RF在未分化关节炎向类风湿关节炎转化的预测价值[J].重庆医学,2015,44(34):4787-4789.
[4]孙利谦,金春林,张志杰,等.免疫比浊法和高效液相色谱法测定糖化血红蛋白一致性的Meta分析[J].中国糖尿病杂志,2016,24(10):885-891.
[15]王琰.酶联免疫吸附法检测HIV_((1+2))抗体时的影响因素[J].解放军医学院学报,2013,34(3):233.
[16]林锦骠,杨滨,欧启水.类风湿关节炎中抗环瓜氨酸肽抗体、类风湿因子浓度与白介素17mRNA表达关系研究[J].现代免疫学,2014,34(5):377-380.
[2]段京明,王瑞明,李祥双,等.细胞因子白细胞介素-6及胰岛素生长样因子-1与类风湿关节炎临床表现的关联性研究[J].中国骨质疏松杂志,2016,22(5):560-562.
[3]王斌,陈竹,李向培,等.少关节起病类风湿关节炎的临床分析[J].中华疾病控制杂志,2017,21(9):935-938.
[4]崔轶霞.三种抗体对老年类风湿关节炎患者的诊断作用比较[J].中国老年学杂志, 2015,35(8):2245-2246.
[5]李禹龙,张瑞,李金明.抗环瓜氨酸肽抗体用于类风湿关节炎临床检测的价值[J].中华检验医学杂志,2014,37(12):903-906.
[6]戴婉如,周欢,林燕辉,等.免疫透射比浊法在AU5800全自动生化分析仪检测降钙素原的方法学评价[J].检验医学与临床,2015,12(10):1447-1448.
[7]温博,曾升平.类风湿关节炎的研究进展[J].世界中西医结合杂志,2014,9(9):1014-1016.
[8]刘靓婧,吴斌,李延萍,等.老年难治性类风湿关节炎的治疗研究进展[J].老年医学与保健,2015,21(6):448-451.
[9]盖楠楠,李国晖.类风湿性关节炎患者血清RF、抗CCP抗体联合检测的临床意义[J].昆明医科大学学报,2017,38(3):111-114.
[10]张静思,陈鑫苹,陈斌.RF、抗-CCP、AKA及GPI联合检测在类风湿关节炎诊断中的价值[J].重庆医学,2015,44(13):1788-1789.
[11]张文兰,胡同平,王永福,等.抗环瓜氨酸肽抗体对类风湿关节炎的诊断、治疗及预后的临床价值[J].中国免疫学杂志,2015,1541(11):1541-1544.
[12]杨梅花,王向红,冯忠军,等.类风湿性关节炎患者血浆Ghrelin水平变化及其与血清CRP、RF、抗-CCP的关系[J].山东医药,2015,55(33):18-20.
[13]关晓东,吴宇芳,陈少莹,等.联合检测ICTP、抗CCP抗体和RF在未分化关节炎向类风湿关节炎转化的预测价值[J].重庆医学,2015,44(34):4787-4789.
[4]孙利谦,金春林,张志杰,等.免疫比浊法和高效液相色谱法测定糖化血红蛋白一致性的Meta分析[J].中国糖尿病杂志,2016,24(10):885-891.
[15]王琰.酶联免疫吸附法检测HIV_((1+2))抗体时的影响因素[J].解放军医学院学报,2013,34(3):233.
[16]林锦骠,杨滨,欧启水.类风湿关节炎中抗环瓜氨酸肽抗体、类风湿因子浓度与白介素17mRNA表达关系研究[J].现代免疫学,2014,34(5):377-380.