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目的:探讨血清14-3-3η蛋白与自身抗体检测对类风湿关节炎(RA)诊断的临床价值。方法:收集134例RA患者、90例非RA关节病变患者及同期40例健康体检者血清样本,采用ELISA和速率比浊法分别检测14-3-3η蛋白、抗CCP抗体(anti-CCP)、抗RA33抗体(anti-RA33)、抗Sa抗体(anti-Sa)和类风湿因子(RF)含量,并分析其对RA的诊断价值。结果:(1)血清14-3-3η蛋白、anti-CCP、anti-RA33、anti-Sa、RF水平在RA组均显著高于非RA组和对照组,组间差异都具有统计学意义;(2)绘制各指标ROC曲线,14-3-3η蛋白、anti-CCP、anti-RA33、anti-Sa、RF曲线下面积(AUC)分别0.831、0.852、0.615、0.706和0.739,均P<0.01;其中14-3-3η蛋白和anti-CCP达到中等以上诊断价值,对应cutoff值分别为2.59 ng/ml和24.10 U/ml;(3)所有指标中anti-Sa特异度最强为97.69%,RF灵敏度最高为83.58%;14-3-3η诊断RA的特异度为91.54%仅稍次于anti-Sa和anti-RA33抗体,但其敏感度较anti-Sa和anti-RA33均高。结论:14-3-3η蛋白、anti-CCP、anti-RA33、anti-Sa和RF在RA中均显著升高,对RA的诊断都有一定的价值。同时,14-3-3η诊断RA的敏感度和特异度相比自身抗体更有一定优势,可以作为辅助诊断RA的指标。
Objective: To investigate the clinical value of serum 14-3-3ηn protein and autoantibodies in the diagnosis of rheumatoid arthritis (RA). Methods: Serum samples from 134 patients with RA, 90 patients with non-RA joint disease and 40 healthy controls were collected. Serum samples of 14-3-3n, anti-CCP, Anti-RA33 antibody, anti-Sa antibody and rheumatoid factor (RF), and to analyze its diagnostic value for RA. Results: (1) The levels of serum 14-3-3n protein, anti-CCP, anti-RA33, anti-Sa and RF in RA group were significantly higher than those in non-RA group and control group (2) The ROC curve of each index was plotted. The area under the curve of 14-3-3n protein, anti-CCP, anti-RA33, anti-Sa and RF curves were 0.831,0.852,0.615,0.706 and 0.739, ; 14-3-3n protein and anti-CCP reached the median diagnostic value, corresponding to a cutoff value of 2.59 ng / ml and 24.10 U / ml, respectively; (3) The highest specificity of all anti-Sa was 97.69% The highest sensitivity of RF was 83.58%. The specificity of 14-3-3η for diagnosis of RA was 91.54% only slightly later than that of anti-Sa and anti-RA33, but the sensitivity was higher than that of anti-Sa and anti-RA33. Conclusion: The levels of 14-3-3n protein, anti-CCP, anti-RA33, anti-Sa and RF in RA are significantly increased, which are of value in the diagnosis of RA. At the same time, 14-3-3η diagnosis of RA sensitivity and specificity compared with autoantibodies more certain advantages, can be used as an auxiliary diagnosis of RA indicators.