«上一篇/Previous Article|本期目录/Table of Contents|下一篇/Next Article»

《天津医科大学学报》[ISSN:1006-8147/CN:12-1259/R]

卷:

26卷

期数:

2020年01期

页码:

68-71

栏目:

临床医学

出版日期:

2020-04-06

文章信息/Info

Title:

Joint detection of anti-CCP, RF and anti-RA33 in rheumatoid arthritis clinical application

文章编号:

1006-8147(2020)01-0068-04

作者:

岳 超¹; 刘 勤²; 白 虹¹

（1.天津医科大学基础医学院免疫学系，天津 300070；2.天津市第五中心医院检验科，天津 300450）

Author(s):

YUE Chao¹;  LIU Qin²;  BAI Hong¹

（1.Department of Immunology, School of Basic Medical Sciences, Tianjin Medical University, Tianjin 300070, China; 2.Clinical Laboratory, Tianjin Fifth Central Hospital, Tianjin 300450, China)

关键词:

类风湿关节炎; 抗环瓜氨酸肽抗体; 类风湿因子; 抗RA33

Keywords:

rheumatoid arthritis; anti-cyclic citrullinated peptide antibody; rheumatoid factor; anti-RA33

分类号:

R392

DOI:

-

文献标志码:

A

摘要:

目的：探讨抗环瓜氨酸肽抗体（抗CCP）、类风湿因子（RF）、抗RA33抗体联合检测在类风湿关节炎（RA）诊断中意义。方法：选取在我院确诊RA患者266例、非RA风湿病患者228例（结缔组织病、强直性脊柱炎、骨关节炎、系统性红斑狼疮、干燥综合征）、健康体检者215名，检测3组抗CCP、RF、抗RA33数值，统计各指标阳性率，并进行统计学分析比较；通过Spearman 相关分析探讨各指标之间的关系；ROC曲线比较各指标的诊断性能；通过平行试验与系列实验探讨3项指标联合检测RA的诊断效能。结果：RA患者各指标数值均显著高于非RA自身免疫疾病患者与健康对照组（P ＜0.01）；Spearman相关分析显示RA患者抗CCP与抗RA33之间不存在关系，RF与抗CCP、RF与抗RA33之间存在显著相关性（P ＜0.01）；ROC曲线分析显示，抗CCP、RF、抗RA33的AUC值分别为0.942、0.922、0.653；3项指标中，阳性率：RF＞抗CCP＞抗RA33,敏感度：RF＞抗CCP＞抗RA33，特异度：抗RA33＞抗CCP＞RF；平行试验敏感度增高（98.50%），但特异度降低（64.91%），系列实验敏感度为15.41%，特异度为98.68%。结论：抗CCP、RF、抗RA33联合检测可提高诊断RA的敏感度与特异性，适用于RA的早期诊断，临床上值得推广使用。

Abstract:

Objective: To explore the significance and application value of combined detection of anti-cyclic citrullinated peptide antibody (anti-CCP),rheumatoid factor (RF) and anti-RA33 antibody in the diagnosis of rheumatoid arthritis (RA). Methods: 266 patients with RA and 228 patients with non-RA rheumatism (connective tissue disease, ankylosing spondylitis, osteoarthritis, systemic lupus erythematosus, Sjogren’s syndrome) and 215 healthy persons were selected. The anti-CCP, RF and anti-RA33 values of the three groups were detected, and the positive rates of each index were counted and analyzed by Spearman correlation analysis. The diagnostic performance of each index was compared by ROC curve, and the diagnostic efficiency of the three indexes was explored by parallel experiment and series experiment. Results: The values of each index in RA patients were significantly higher than those in non-RA patients with autoimmune diseases and healthy control group (P ＜0.01); Spearman correlation analysis showed that there was no relationship between anti-CCP and anti-RA33 in RA patients, but there was a significant correlation between RF and anti-CCP, RF and anti-RA33 (P ＜0.01); ROC curve analysis showed that the AUC values of anti-CCP, RF and anti-RA33 were 0.942, 0.922 and 0.653, respectively. The positive rate was RF＞anti-CCP＞anti-RA33, sensitivity: RF＞anti-CCP＞anti-RA33, specificity: anti-RA33＞anti-CCP＞RF；the sensitivity of parallel test increased (98.50%), but specificity decreased (64.91%), sensitivity of series test was 15.41%, specificity was 98.68%. Conclusion: The combined detection of anti-CCP, RF, anti-RA33 and anti-RA33 can improve the sensitivity and specificity in the diagnosis of RA, which is suitable for the early diagnosis of RA and is worth popularizing in clinic.

参考文献/References:

[1] Phuan-Udom R, Lektrakul N, Katchamart W. The association between 10-year fracture risk by FRAX and osteoporotic fractures with disease activity in patients with rheumatoid arthritis[J]. Clin Rheumatol, 2018 , 37(10):2603
[2] Thenganatt M A, JanKovic J. Parkinson Disease subtypes[J]. JANA Neurol, 2014,71(4):499
[3] Shakiba Y, Koopah S, Jamshidi A R, et al. Anti-cyclic citrullinated peptide antibody and rheumatoid factor isotypes in Iranian patients with rheumatoid arthritis:evalunation of clinical value and association with disease activity[J]. Iran J Allergy Asthma Immunol,2014,13(3):147
[4] Cheon Y H, Lee S G, Kim M, et al. The association of disease activity, pro-inflammatory cytokines, and neurotrophic factors with depression in patients with rheumatoid arthritis[J]. Brain Behav Lummun, 2018,73: 274
[5] Lieve V H, Julie J, Bert V C, et al. Performance characteristics of rheumatoid factor and anti-cyclic citullinated peptide antibody assays may impact ACR/EULAR classification of rheumatoid arthritis[J]. Ann rheumat dis, 2015,18(1):29
[6] 张琼,罗以勤,汪元,等. 4种血清标志物在类风湿关节炎的诊断、疾病活动度的判断及骨侵蚀的预测的应用价值[J]. 安徽医科大学学报, 2015,50（12）：1791
[7] 王光彦,高冬花,龚丽坤,等. 抗环瓜氨酸肽抗体和类风湿因子分型联合检测在类风湿关节炎诊断中的应用[J].国际检验医学杂志, 2016,37（5）：696
[8] Fangxiang M, Hong W, Yong W. A retrospective study: the significance of combined tseting of serum markers for diagnosis of rheumatoid arthritis[J]. Med Sci Mon Bas Res, 2017(23):295
[9] Verheul M K, B?觟hringer S,van Delft M A M, et al. Triple positivity for anti-citrullinated protein autoantibodies, rheumatoid factor, and anti-carbamylated protein antibodies conferring high specificity for rheumatoid arthritis: implications for very early identification of at-risk individuals[J]. Arthritis Rheumatol, 2018,70(11):1721
[10] Gomez E L, Gun S C, Somanath S D, et al. Ethnic differences in the prognostic utility of rheumatoid factor isotypes and anticyclic citrullinated peptides in rheumatoid arthritis patients:a cross-sectional study[J]. Mod Rheumatol, 2013,23(4):716
[11] 陈华,胡彦,陈娟娟,等.抗CCP、RF、AKA、RA33/36抗体在类风湿关节炎早期诊断中的作用[J] .实验与检验医学杂志,2016,8（34）：470

相似文献/References:

[1]明建松,王晓雪,杨梦晨,等.MiR-145-5p对胶原诱导的关节炎小鼠关节炎症的影响[J].天津医科大学学报,2019,25(02):115.
　MING Jian-song,WANG Xiao-xue,YANG Meng-chen,et al.Effects of miR-145-5p on joint inflammation in collagen-induced arthritis mice[J].Journal of Tianjin Medical University,2019,25(01):115.
[2]刘 勤,张学军,岳 超.中性粒细胞与淋巴细胞比值在类风湿关节炎诊断中的价值分析[J].天津医科大学学报,2019,25(04):366.
　LIU Qin,ZHANG Xue-jun,YUE Chao.Value of the ratio of neutrophil to lymphocyte in the diagnosis of rheumatoid arthritis[J].Journal of Tianjin Medical University,2019,25(01):366.
[3]王伟远,刘丹丹,张蓓,等.类风湿关节炎患者血清14-3-3η蛋白水平及临床检测价值的初步研究[J].天津医科大学学报,2022,28(01):95.
　WANG Wei-yuan,LIU Dan-dan,ZHANG Bei,et al.Preliminary study on serum 14-3-3η protein level and clinical detection value in patients with rheumatoid arthritis[J].Journal of Tianjin Medical University,2022,28(01):95.
[4]赵妍,赵晶晶,刘爱芬,等.基于网络药理学探讨托法替布联合甲氨蝶呤治疗 类风湿关节炎的作用机制[J].天津医科大学学报,2022,28(03):272.
　ZHAO Yan,ZHAO Jing-jing,LIU Ai-fen,et al.Systematic elaboration of the mechanism of tofacitinib combined with methotrexate in the treatment of rheumatoid arthritis via network pharmacology[J].Journal of Tianjin Medical University,2022,28(01):272.

备注/Memo

备注/Memo:

作者简介 岳超（1986-）男，初级技师，硕士在读，研究方向: 临床免疫学；通信作者: 白虹, E-mail:hongbai25@163.com。

常用功能

更新日期/Last Update: 2020-04-16