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目的:评价抗环瓜氨酸肽(CCP)抗体和类风湿性关节炎因子(RF)在类风湿性关节炎(RA)中的意义。方法:对90例RA患者、30例其他疾病患者和35例健康对照组血清用ELISA法检测抗CCP抗体、免疫散射比浊法检测RF,比较两种抗体单独或联合检测对诊断RA的敏感性、特异性、阳性预测值、阴性预测值、总符合率及Youden指数;探讨抗CCP抗体和RF的相关性,通过绘制ROC曲线,计算ROC曲线下面积(ACU)。结果:RA组抗CCP抗体和RF阳性率均高于其他疾疾患者和健康对照组(P<0.05);RF诊断RA的敏感性高于抗CCP抗体;抗CCP抗体对论断RA的其它5项指标均高于RF;抗CCP抗体和RA联合检测对RA的诊断的敏感性明显高于抗CCP抗体、RF两项检测指标;另外,抗CCP抗体和RA联合检测对RA的诊断的的阴性预测值,总符合率及Yiuden指数也高于抗CCP抗体、RF两项检测指标。抗CCP抗体、RF及两者联合检测ROC曲线下面积(ACU)均>0.5,并且抗CCP抗体与RF联合检测AUC大于抗CCP抗体及RF的AUC。结论:抗CCP抗体对RA有较高的诊断价值。和RF联合检测对诊断RA有重要意义。
AIM: To evaluate the significance of anti-cyclic citrullinated peptide (CCP) antibodies and rheumatoid arthritis (RF) in rheumatoid arthritis (RA). Methods: Serum anti-CCP was detected by ELISA in 90 patients with RA, 30 patients with other diseases and 35 healthy controls. The immunofluorescence turbidimetry was used to detect the anti-CCP. The sensitivity of the two antibodies to RA alone or in combination was also compared , Specificity, positive predictive value, negative predictive value, total coincidence rate and Youden index; to explore the correlation between anti-CCP antibody and RF, and to plot the area under the ROC curve (ACU) by plotting the ROC curve. Results: The anti-CCP antibody and RF positive rate in RA group were higher than those in other diseases and healthy control group (P <0.05). The sensitivity of RF in diagnosing RA was higher than that of anti-CCP antibody. The indexes were higher than that of RF; the sensitivity of anti-CCP antibody and RA combined detection was significantly higher than that of anti-CCP antibody and RF; in addition, the negative predictive value of anti-CCP antibody and RA for the diagnosis of RA Value, total coincidence rate and Yiuden index also higher than the anti-CCP antibody, RF two test indicators. The area under the ROC curve (ACU) of anti-CCP, RF and the combined detection of both were> 0.5, and the AUC of anti-CCP antibody and RF combined detection was higher than that of anti-CCP antibody and RF. Conclusion: Anti-CCP antibody has high diagnostic value for RA. And RF combined detection of RA is of great significance.