摘要
目的分别评价单独和联合检测抗环瓜氨酸肽抗体(anti-CCP)和类风湿因子(RF)等临床指标在诊断类风湿关节炎(RA)中的作用。方法速率散射比浊法检测RF;酶联免疫吸附试验(ELISA)检测anti-CCP;间接免疫荧光法检测抗角蛋白抗体(AKA)和抗核周因子抗体(APF)。结果 anti-CCP的敏感性与RF相比无显著性差异(P>0.05),但特异性显著高于RF(P<0.05)。敏感性明显高于AKA和APF(P<0.05),特异性与这些指标相比无显著性差异(P>0.05)。与anti-CCP相比,检测anti-CCP/RF时,不能明显提高敏感性(P>0.05),特异性却显著下降(P<0.05)。检测anti-CCP/AKA或anti-CCP/APF的敏感性和特异性均无显著变化(P>0.05),检测anti-CCP/RF/AKA/APF,特异性显著下降(P<0.05)。联合anti-CCP+RF、AKA、APF检测,特异性与单独检测anti-CCP相当(P>0.05),但敏感性均显著下降(P<0.05)。结论单独检测anti-CCP对于诊断RA优于单独检测RF,且联合antiCCP与RF、AKA、APF并不能显著提高敏感性和特异性。推荐采用单独检测anti-CCP代替RF作为诊断RA的实验室指标。
Objective To evaluate the effectiveness of using anti-CCP as the single laboratory parameter for RA di- agnosis, versus to use anti-CCP, RF, and other parameters in combination. Material and methods level of RF was meas- ured by rate scattering turbidimetry method; anti-CCP level was measured by ELISA; level of AKA and APF were measured by indirect immunofluorescent assay. Results For diagnosis of RA,there＇s no significant difference in sensi- tivity between anti CCP and RF （P 0. 05）, However, specificity of anti-CCP is significantly higher than RF （P 0.05）. Compared to AKA and APF,the sensitivity of anti-CCP measurement is significantly higher（P%0.05） ,with no significant difference in specificity. Compared to using anti-CCP alone,to use both anti-CCP and RF for RA diagnosis, there was no significantly improvement of sensitivity,whereas the specificity dropped significantly. To use anti-CCP in combination with either AKA or APF, there were no significant changes in both the sensitivity and specificity. Anti- CCP in combination with RF, with AKA,and with APF, compared to anti-CCP alone, had significantly lower specificity （P%0.05）. Compared with anti-CCP alone, when anti-CCP measurement was combined with all three other parameters （RF,AKA, and APF）, there was no significant difference in specificity, but sensitivity was significantly lower （P 0.05）Conclusion anti-CCP level alone for RA diagnosis is more effective than RF measurement; combination of anti- CCP measurement with RF, AKA,and APF did not significantly improve the sensitivity and specificity. We recommend that anti-CCP measurement alone is sufficient and can replace RF measurement for RA diagnosis.
出处
《中国实验诊断学》
2014年第1期94-97,共4页
Chinese Journal of Laboratory Diagnosis
