摘要
目的探讨隐匿型类风湿因子(HRF)IgM、抗环瓜氨酸肽(CCP)抗体、抗角蛋白抗体(AKA)联合检测对幼年特发性关节炎(JIA)的诊断价值。方法用酶联免疫吸附试验(ELISA)对60例JIA、27例系统性红斑狼疮(SLE)、18例川崎病、50例健康对照组儿童血清行抗CCP抗体、类风湿因子(RF)检测;用间接免疫荧光法进行AKA检测;利用葡聚糖凝胶A-50为层析柱在酸性条件下分离出RF,再用ELISA测定HRF-IgM。结果抗CCP抗体阳性率21.7%(13/60),特异性96.8%;RF在JIA与非JIA组中阳性率无差异(χ2=0.17P=0.68);AKA与抗CCP抗体结果相近,敏感性差,特异性高;HRF-IgM敏感性65%,特异性85.3%JIA与非JIA组有极显著性差异(χ2=40.22P=0.0001)。结论抗CCP抗体及AKA敏感性低,特异性高,单独作为JIA的诊断指标有一定的局限性;HRF-IgM敏感性及特异性高,作为JIA诊断指标较好;三者联合对提高JIA的诊断率更有价值。
Objective To explore the significance of hidden rheumatoid factor - IgM （ HRF - IgM）, anti - cyclic citullinated peptide antibodies （anti- CCP）, antikeratin antibodies （AKA） combined test in the diagnosis of juvenile idiopathic arthritis （JIA）, Methods The anti - CCP and rheumatoid factors（RF） were tested by enzyme linked immunosorbent assay（ELISA） in serum samples from 60 children with JIA, 27 systemic lupus erythematosus（ SLE）, 18 kawaski diseases and 50 healthy children who were enrolled to serve as normal controls. Indirect immumofluorescence method was used to test AKA. Using the QAE - Sephadex - A50 to separate RF then tested HRF - lgM by ELISA. Results Positive anti - CCP were found in sera of 13 patients with JIA （ 21.7 % ） and specificity 96.8 %. RF were found lower test both with the JIA and other groups（χ^2 =0.17 P = 0. 68 ）. The results of AKA were similar to the anti - CCP, they were both lower sensitivity and higher specificity. There were 65% sensitivity and 85.3% specificity in the HRF - IgM, and great significant difference in positive rate in JIA and other group （ χ^2= 40.22 P = 0. 0001 ）. Conclusions JIA children in the studied series has a higher detection rate and value of HRF - IgM as compared to the other control groups. HRF - IgM,anti - CCP,AKA combined test in JIA can prove to be a valuable reference index for diagnosing suspected JIA children,
出处
《实用儿科临床杂志》
CAS
CSCD
北大核心
2007年第9期680-681,共2页
Journal of Applied Clinical Pediatrics
关键词
关节炎
幼年特发性
隐匿型类风湿因子IgM
抗角蛋白抗体
抗环瓜氨酸肽抗体
juvenile idiopathic arthritis
hidden rheumatoid factor - IgM
anti - cyclic citrullinated peptide antibodies
antikeratin anti- bodies
