四种抗体联合检测在类风湿关节炎早期诊断中的应用价值

目的 探讨抗核周因子抗体(APF)、抗角蛋白抗体(AKA)、类风湿因子(RF)、抗环瓜氨酸肽抗体(抗-CCP抗体)联合检测在类风湿关节炎(RA)早期诊断中的临床应用价值。方法 对RA患者127例、非RA其他风湿病患者102例及正常对照组43例，采用速率散射免疫比浊法检测RF；酶联免疫吸附法定量检测抗-CCP抗体；免疫荧光法检测AKA、APF，并采用四格表法计算敏感度及特异性。结果RA组的RF、APF、AKA、抗-CCP抗体敏感度分别为65．4％、48．8％、32．3％、83．5％，特异性分别为73．5％、92．2％、93．1％、94．1％，同时出现三种抗体和四种抗体的特异性为99．0％、100％；非RA组无四种抗体同时出现的情况。结论 RF敏感性较高，但特异性较差；APF、AKA、抗-CCP抗体三种自身抗体对RA具有高度特异性，且在RA早期即可出现。四种抗体联合检测有助于提高RA的早期诊断率。

Clinical value of the combined detection of APF,AKA,RF and anti-CCP antibody in the early diagnosis of rheumatoid arthritis

Objective To explore the clinic value of the combined detection of APF,AKA,RF and anti-CCP antibody in the early diagnosis of rheumatoid arthritis(RA).Methods RF was measured by the rate scatting immunity method.Anti-CCP antibody was measured by ELISA,AKA and APF were measured by immunity fluorescence method in 127 patients with RA and in 102 patients without RA and in 43 normal controls.Sensitivity and speciality were calculated.Results The sensitivity of RF,APF,AKA,anti-CCP antibody were 65.4%,48.8%,32.3%,83.5% respectively;the speciality of RF,APF,AKA,anti-CCP antibody were 73.5% ,92.2%,93.1%,94.1% respectively in RA patients.The speciality were 99.0% and 100% in RA patients with three or four kinds of antibodies positive.All four kinds of antibodies were not positive in same time in patients without RA.Conclusions RF has high sensitivity and low speciality in early diagnosis of RA,but APF,AKA,anti-CCP antibody have high speciality.Thus the combined detection of four antibody may help the diagnosis of RA.