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目的:评价抗环瓜氨酸多肽(anti-CCP)抗体和抗突变型瓜氨酸化波形蛋白(anti-MCV)抗体对类风湿性关节炎(RA)的诊断价值。方法:我们采用酶联免疫吸附试验(ELISA)对62例早期类风湿性关节炎病人血清、25例系统性红斑狼疮(SLE)病人血清、18例原发性干燥综合征(SS)病人血清、17例混合性结缔组织病(MCTD)和32例健康人血清进行anti-MCV和anti-CCP测试。采用免疫比浊法测定血清中RF含量。从实验数据中得到各实验指标的灵敏度和特异性。通过统计学分析,评价anti-MCV和anti-CCP与RA的相关性。结果:anti-MCV、anti-CCP和RF对RA的敏感度分别为80.6%(50/62)、69.4%(43/62)和72.6%(45/62),特异性分别为95%、93%和81.7%。联合检测anti-MCV和anti-CCP对RA的特异性增加,为95.8%,但敏感度降低,为61.3%。如同时检测anti-MCV和anti-CCP,并以二者中任何一种指标为阳性标准,那么,对RA的敏感性和特异性分别为86.5%和92.6%。结论:Anti-CCP和anti-MCV是诊断RA的高特异性和敏感性的检测指标,联合检测anti-MCV和anti-CCP较单一检测anti-MCV或anti-CCP具有更好的RA诊断价值。
Objective: To evaluate the diagnostic value of anti-CCP and anti-MCV antibody in the diagnosis of rheumatoid arthritis (RA). Methods: Serum samples of 62 patients with early rheumatoid arthritis, 25 patients with systemic lupus erythematosus (SLE), 18 patients with primary sjogren’s syndrome (SS) were analyzed by enzyme-linked immunosorbent assay (ELISA) 17 cases of mixed connective tissue disease (MCTD) and 32 healthy human serum anti-MCV and anti-CCP test. Immunoturbidimetry was used to determine the content of RF in serum. The sensitivity and specificity of each experimental index were obtained from the experimental data. The correlation between anti-MCV and anti-CCP and RA was evaluated by statistical analysis. Results: The sensitivities of anti-MCV, anti-CCP and RF to RA were 80.6% (50/62), 69.4% (43/62) and 72.6% (45/62), respectively, with the specificity of 95% % And 81.7%. The combined detection of anti-MCV and anti-CCP increased the specificity of RA to 95.8%, but the sensitivity decreased to 61.3%. If both anti-MCV and anti-CCP were tested at the same time, and either of the two indicators were positive, then the sensitivity and specificity for RA were 86.5% and 92.6%, respectively. Conclusions: Anti-CCP and anti-MCV are the diagnostic criteria for the high specificity and sensitivity of RA. Combined detection of anti-MCV and anti-CCP has better RA diagnostic value than anti-MCV or anti-CCP alone.