抗丝集蛋白抗体谱检测在类风湿性关节炎诊断中的临床意义.doc

抗丝集蛋白抗体谱检测在类风湿性关节炎诊断中的临床意义 医学检验杂志2005年6月第6卷第期C— hinese— Journa— lofMed— icalLabo— ra — toryTechnology,.1un2005,Vo1.6No.3l77 【实验研究】 【ExperimentalStudy】 抗丝集蛋白抗体谱检测在类风湿性关节炎诊断中的临床意义 DETECTIONOFANTIFILAGGRINAUTOANTIBODIESFORDIAGNOSIS OFRHEUMATOIDARTHRITIS 张蜀澜李永哲佟大伟 (中医学科学院中同协和医科大学北京协和医院检验科,北京100730) 摘要[目的]评价抗环瓜氨酸肽抗体(抗一CCP抗体),抗丝集蛋白抗体(AFA),抗角蛋白抗体(AKA),抗核周因子抗体 (APF)对于类风湿性关节炎(RA)诊断的特异性及敏感性,以及各项检测指标之问的相关性,探讨4项指标联合检测的临床应用 前景[方法]用酶联免疫吸附法(ELISA)检测88例RA,32例其他自身免疫性疾病患者和25名健康人血清中的抗一CCP抗体和 AFA,AKA和APF采用间接免疫荧光法检测.[结果]在88例RA患者中抗一CCP抗体,AFA,AKA和APF的敏感性分别为 88.64%,70.45%,63.64%,61.36%,特异性分别为92.98%,91.23%,94.74%,91.23%,抗一CCP抗体的敏感性高于AFA,AKA 和APF.抗一CCP抗体,AFA与AKA,APF之问具有相关性.『结论]抗一CCP抗体对RA诊断具良好的敏感性和特异性.可临床 用于RA的诊断. 关键词类风湿关节炎;抗环瓜氨酸肽抗体;抗丝集蛋白抗体;抗角蛋自抗体;抗核周因子抗体 Detectionofantifilaggrinautoantibodiesfordiagnosisofrheumatoidarthritis ZhangShulan,LiYongzhe,TongDawei.DepartmentofLaboratoryTests,PekingUnionMedicalCollegeHospital,Beijing100730,China Abstract[objective]Todeterminethediagnosticvalueofanti—cycliccitrullinatedpeptideantibodies(anti—CCP),antibodiesto filaggrin(AFA),anti—keratinantibody(AKA)andanti—pemuclearfactor(APF)forrheumatoidarthritis(RA)andexplorethecolTela— tionamongthe4indexes.[Methods]Anti—CCPandAFAweredeterminedbyELISAin88serumsamplesfromthepatientswithRA,32 fromthosewithotherrheumatoiddiseasesand25fromthehealthycontrols.AKAandAPFweredeterminedinthesamesamplesbyindirect immunfluorescentassay.[Results]Thesensitivityofanti—CCP,AFA,AKAandAPFwas88.64%,70.45%,63.64%and61.36% andtheirspecificitywas92.98%,91.23%,94.74%and91.23%.respectively,fordiagnosisofRA.Anti—CCPwasmoresensitivethan theother3indexes.Meanwhile.anti—CCPwascorrelatedtotheotherindexes.『Conclusion]Thedetectionofanti—CCPisusefulfordi— agnosisofRAbecauseofitshighsensitivityandspecificity. KeywordsRheumatoidarthritis;Anti—cycliccitrullinatedpeptideantibody;Antibodytofilaggrin;Anti—keratinantibod- Y;Anti—pernuclearfactor [中分类号]11593.22[文献标识码]A[文章编号]1606—8025(2005)03—177—03 类风湿性关节炎(rheumatoidarthrits,RA)是一种以侵犯关 作者简介:张蜀澜(1978一),女,