抗CCP抗体、抗MCV抗体和类风湿因子在早期类风湿关节炎中的诊断价值
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摘要
目的探讨抗CCP抗体、抗MCV抗体和类风湿因子在早期类风湿关节炎中的诊断价值。方法选择于2016年1月至2017年1月期间在我院就诊的早期类风湿关节炎(RA)患者及其他骨关节病患者各40例,并选择40名同期在我院体检的健康人作为研究对象。其中风湿关节炎患者设为RA组,其他骨关节病患者为疾病对照组,健康人为正常对照组。采用免疫透射比浊法、酶联免疫吸附法(ELISA)、免疫散射比浊法分别测定三组的抗环瓜氨酸肽(CCP)抗体、抗突变型瓜氨酸波形蛋白(MCV)抗体及IgM型类风湿因子(IgM-RF)水平,比较抗CCP抗体、抗MCV抗体、IgM-RF单独检测及三个指标联合检测对早期类风湿性关节炎的诊断价值。结果①RA组的抗CCP抗体、抗MCV抗体、IgM-RF水平均明显高于疾病对照组与正常对照组,差异具有统计学意义(P<0.05);疾病对照组与正常对照组间差异无统计学意义(P>0.05)。②RA组的抗CCP抗体、抗MCV抗体、IgM-RF及联合检测的阳性率均明显高于疾病对照组与正常对照组,差异具有统计学意义(P<0.05);疾病对照组与正常对照组间差异无统计学意义(P>0.05)。③联合检测的灵敏度及阴性预测值均明显高于抗CCP抗体、抗MCV抗体、IgM-RF单独检测,差异具有统计学意义;抗CCP抗体与抗MCV抗体的特异性及阳性预测值均明显高于IgM-RF及联合检测,差异具有统计学意义(P<0.05)。结论早期RA患者的血清中存在抗CCP抗体、抗MCV抗体、IgM-RF的高表达,且其灵敏度及特异性均较高,临床上可联合检测抗CCP抗体、抗MCV抗体及IgM-RF,以提高RA的早期诊断率。
Objective To investigate the diagnostic values of anti-CCP antibody,anti-MCV antibody and rheumatoid factor in early rheumatoid arthritis.Methods We selected 40 patients with early rheumatoid arthritis(RA)and other osteoarthrosis patients who were treated in our hospital from January,2016 to January,2017 for the study,and also selected 40 healthy people who were in our hospital during the same period as controls.Among them,rheumatoid arthritis patients were set to RA group,other osteoarthrosis patients were included in the disease control group,and healthy people were the normal control group.Among three groups,anti-cyclic citrullinated peptide(CCP)antibodies,anti-mutated citrullin vimentin(MCV)antibodies and IgM-type rheumatoid factor(IgM-RF)were determined by immunoturbidimetry,enzymelinked immunosorbent assay(ELIS A)and immunoturbidimetry.Across groups,we compared with anti-CCP antibody,anti-MCV antibody,IgM-RF alone,or the combined detection of three indicators for the diagnosis of early rheumatoid arthritis.Results ①The levels of anti-CCP,anti-MCV and IgM-RF in RA group were significantly higher than those in the disease control group and normal control group,(P<0.05).Between the disease control group and normal control group,there was no significant difference(P>0.05).②The positive rates of anti-CCP antibody,anti-MCV antibody,IgM-RF and combined detection in RA group were significantly higher than those in the disease control group and normal control group,(P<0.05).There was no significant difference between the disease control group and normal control group(P>0.05).③The sensitivity and negative predictive value of combined detection were significantly higher than those of antiCCP antibody,anti-MCV antibody or IgM-RF alone.The specificity and positive predictive value of antiCCP antibody and anti-MCV antibody were significantly higher than IgM-RF alone and combined detection,(P<0.05).Conclusion The serum of early RA patients has high expressions of anti-CCP antibody,antiMCV antibody and IgM-RF,with high sensitivity and specificity.The combined detections of anti-CCP antibody,anti-MCV antibody and IgM-RF can be used to improve the early diagnosis rate of RA.
Objective To investigate the diagnostic values of anti-CCP antibody,anti-MCV antibody and rheumatoid factor in early rheumatoid arthritis.Methods We selected 40 patients with early rheumatoid arthritis(RA)and other osteoarthrosis patients who were treated in our hospital from January,2016 to January,2017 for the study,and also selected 40 healthy people who were in our hospital during the same period as controls.Among them,rheumatoid arthritis patients were set to RA group,other osteoarthrosis patients were included in the disease control group,and healthy people were the normal control group.Among three groups,anti-cyclic citrullinated peptide(CCP)antibodies,anti-mutated citrullin vimentin(MCV)antibodies and IgM-type rheumatoid factor(IgM-RF)were determined by immunoturbidimetry,enzymelinked immunosorbent assay(ELIS A)and immunoturbidimetry.Across groups,we compared with anti-CCP antibody,anti-MCV antibody,IgM-RF alone,or the combined detection of three indicators for the diagnosis of early rheumatoid arthritis.Results ①The levels of anti-CCP,anti-MCV and IgM-RF in RA group were significantly higher than those in the disease control group and normal control group,(P<0.05).Between the disease control group and normal control group,there was no significant difference(P>0.05).②The positive rates of anti-CCP antibody,anti-MCV antibody,IgM-RF and combined detection in RA group were significantly higher than those in the disease control group and normal control group,(P<0.05).There was no significant difference between the disease control group and normal control group(P>0.05).③The sensitivity and negative predictive value of combined detection were significantly higher than those of antiCCP antibody,anti-MCV antibody or IgM-RF alone.The specificity and positive predictive value of antiCCP antibody and anti-MCV antibody were significantly higher than IgM-RF alone and combined detection,(P<0.05).Conclusion The serum of early RA patients has high expressions of anti-CCP antibody,antiMCV antibody and IgM-RF,with high sensitivity and specificity.The combined detections of anti-CCP antibody,anti-MCV antibody and IgM-RF can be used to improve the early diagnosis rate of RA.
引文
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[5]王文琴,翁巍,施金俏,等.抗CCP抗体、抗MCV抗体与RF检测在早期类风湿关节炎诊断中的价值[J].浙江实用医学,2013,18(6):413.
[6]芦晓丽.AKA APF抗CCP抗体抗MCV抗体联合检测在早期类风湿关节炎中的诊断价值[J].基层医学论坛,2017,21(17):2252-2253.
[7]VOSSENAAR E R,DESPRESIV,LAPOINTE E,et al.Rheumatoid arthritis specific anti-Sa antibodies target citrullinaated vimentin[J].Arthritis Res Ther,2004,6(2):R142-R150.
[8]侯娟,叶红珍.类风湿性关节炎与血清抗-CCP抗体、RF、CRP及ESR的相关性研究[J].当代医药论丛,2016,14(6):30-31.
[9]代美玉.抗MCV抗体在早期类风湿关节炎中的诊断意义[D].大连医科大学,2013:19.
[10]赵金霞,王志敏,栗占国.以抗环瓜氨酸肽抗体改进对1987年美国风湿病学会关于类风湿关节炎分类标准的探讨[J].中华风湿病学杂志,2009,13(4):236-239.
[11]SWART A,BURLINGAME R W,G(U|¨)RTLER I,et al.Third generation anti-cit-rullinated peptide antibody assay is a sensitive marker in rheumatoid factor negative rheumatoid arthritis[J].Clin Chim Acta,2012,414:266-272.
[12]张杨文.类风湿性关节炎血清RF与抗-CCP抗体浓度检测及其意义[J].实用医学杂志,2015,31(1):108-109.
[2]祝辉.联合检测抗CCP抗体和RF在诊断类风湿关节炎中的意义[J].实验与检验医学,2017,35(3):398-399.
[3]RAHMAN M T,DEWAN M N A,AHMED A,et al.A timedependent collisional sheath model for dual-frequency capacitively coupled RF plasma[J].IEEE Trans Plasma Sci,2013,41(1):17-23.
[4]王波,牛莉莉,常波,等.联合检测RF、AKA、抗CCP抗体和CRP对RA的诊断价值[J].中国实验诊断学,2016,20(3):425-428.
[5]王文琴,翁巍,施金俏,等.抗CCP抗体、抗MCV抗体与RF检测在早期类风湿关节炎诊断中的价值[J].浙江实用医学,2013,18(6):413.
[6]芦晓丽.AKA APF抗CCP抗体抗MCV抗体联合检测在早期类风湿关节炎中的诊断价值[J].基层医学论坛,2017,21(17):2252-2253.
[7]VOSSENAAR E R,DESPRESIV,LAPOINTE E,et al.Rheumatoid arthritis specific anti-Sa antibodies target citrullinaated vimentin[J].Arthritis Res Ther,2004,6(2):R142-R150.
[8]侯娟,叶红珍.类风湿性关节炎与血清抗-CCP抗体、RF、CRP及ESR的相关性研究[J].当代医药论丛,2016,14(6):30-31.
[9]代美玉.抗MCV抗体在早期类风湿关节炎中的诊断意义[D].大连医科大学,2013:19.
[10]赵金霞,王志敏,栗占国.以抗环瓜氨酸肽抗体改进对1987年美国风湿病学会关于类风湿关节炎分类标准的探讨[J].中华风湿病学杂志,2009,13(4):236-239.
[11]SWART A,BURLINGAME R W,G(U|¨)RTLER I,et al.Third generation anti-cit-rullinated peptide antibody assay is a sensitive marker in rheumatoid factor negative rheumatoid arthritis[J].Clin Chim Acta,2012,414:266-272.
[12]张杨文.类风湿性关节炎血清RF与抗-CCP抗体浓度检测及其意义[J].实用医学杂志,2015,31(1):108-109.