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目的:探讨类风湿因子(Rheum atoid factor,RF)、抗角质蛋白抗体(AKA)、C-反应蛋白(C-reactiveprote in,CRP)和血沉(erythrocyte sed im entation rate,ESR)联检对类风湿关节炎(rheum atoid arthritis,RA)的临床诊断价值。方法:对35例类风湿关节炎患者、30例系统性红斑狼疮和30名正常健康体检者的RF、AKA、CRP及ESR检测,应用速率散射比浊法测定RF和CRP;间接免疫荧光法检测AKA;应用魏氏法测定ESR值。结果:35例RA患者血清中,RF灵敏度和特异性分别为71.4%、91.7%,AKA灵敏度和特异性分别为34.3%、96.7%,CRP灵敏度和特异性分别为91.4%、25%,ESR灵敏度和特异性分别为88.6%、83.3%。联检RF和AKA的灵敏度和特异性分别为81.2%、99.7%,联检RF、AKA、CRP及ESR的灵敏度和特异性分别为99.98%、99.97%。结论:RF、AKA、CRP及ESR可作为RA诊断的血清学指标,且四者联检有助于提高RA诊断的灵敏度及特异性。
Objective: To investigate the effect of rheumatoid arthritis (RF), anti-keratin antibody (AKA), C-reactive protein (CRP) and erythrocyte sed im entation rate (ESR) Clinical value of rheumatoid arthritis (RA). Methods: RF, AKA, CRP and ESR were detected in 35 patients with rheumatoid arthritis, 30 patients with systemic lupus erythematosus and 30 normal healthy subjects. The rate of nephelometry and CRP were measured by nephelometry. Indirect immunofluorescence assay AKA; application of Wei’s method for the determination of ESR value. Results: The sensitivity and specificity of RF in 71 RA patients were 71.4% and 91.7%, respectively. The sensitivity and specificity of AKA were 34.3% and 96.7%, respectively. The sensitivity and specificity of CRP were 91.4%, 25%, respectively. The sensitivity of ESR And specificity were 88.6% and 83.3% respectively. The sensitivity and specificity of joint RF and AKA were 81.2% and 99.7% respectively. The sensitivity and specificity of RFA, AKA, CRP and ESR were 99.98% and 99.97% respectively. Conclusion: RF, AKA, CRP and ESR can be used as serological markers for the diagnosis of RA, and the combination of the four can help to improve the sensitivity and specificity of RA diagnosis.