摘要
评价抗突变型瓜氨酸波形蛋白(抗MCV)在类风湿关节炎(RA)诊断中的价值。检测225例RA患者,253例其他风湿病患者以及80例正常对照血清中抗MCV、抗CCP和RF-IgM的水平,比较抗MCV、RF-IgM及抗CCP在RA的诊断中的意义。结果表明:①抗MCV、RF-IgM、抗CCP对RA的敏感性分别为90.67%、86.22%、76.00%,特异性分别为89.49%、86.79%、93.39%;②抗MCV与抗CCP检测对RF阴性RA病例的诊断有一定价值(67.74%和29.03%);③抗MCV、抗CCP与RF-IgM之间均显著相关(P<0.01);④抗MCV与年龄、病程、功能分级、压痛关节数、ESR、CRP、晨僵持续时间及Sharp评分存在相关(P<0.01或P<0.05),而与双手平均握力、肿胀关节数、DAS28无关(P>0.05)。抗MCV对RA有较高的诊断价值,同抗CCP相比较,其特异性偏低但敏感性则较高。抗MCV能一定程度反应RA的临床病情,且与关节破坏密切相关,可作为RA的血清学指标。
The anti-mutant citrullinated vimentin （anti-MCV） antibody was detected in 225 patients with rheumatoid arthritis （RA）,253 patients with other rheumatic diseases and 80 healthy controls in order to analyze the diagnostic value of anti-MCV antibody detection for RA. The diagnostic value of anti-MCV,immunoglobulin M rheumatoid factor （IgM-RF） and anti-cyclic citrullinated peptide （anti-CCP） were assessed and compared. It was demonstrated that the sensitivity and specificity of anti-MCV,IgM-RF and anti-CCP in 225 patients were 90.67%,89.49%;86.22%,86.79%;76.00%,93.39% respectively. Anti-MCV and anti-CCP antibodies were both valuable diagnostic parameters for RA especially in RA patients with negative RF （67.74% and 29.03%positive respectively）. Anti-MCV antibodies presented a significantly positive correlation with anti-CCP and IgM-RF （P〈0.01）. Anti-MCV antibodies presented positive correlation with age,course of disease,grade of joint function,number of tendered joints,ESR,CRP,modified Sharp scores and duration of morning stiffness （P〈0.01 or P〈0.05）. However,no correlation was found between anti-MCV antibodies and DAS28 score（P〉0.05）. It is evident that anti-MCV antibodies exhibit a good diagnostic value and a correlation with radiological joint damage and the stability of the disease. Compared with the anti-CCP,its specificity is lower but the sensitivity is rather higher. Therefore,anti-MCV seems to be a valuable index for the diagnosis of RA.
出处
《现代免疫学》
CAS
CSCD
北大核心
2010年第4期318-323,共6页
Current Immunology
基金
国家中医药管理局十一五重点专科资助项目
上海市医学重点专科资助项目
上海市科委资助项目(07JC14070)
上海市长宁区关节病诊疗中心和长宁区科研基金资助项目
关键词
类风湿关节炎
抗突变型瓜氨酸波形蛋白
类风湿因子
抗环瓜氨酸肽抗体
rheumatoid arthritis
anti-mutated citrullinated vimentin antibodies
rheumatoid factor
anti-cyclic citrullinated peptide antibodies
