抗環瓜氨酸肽抗體和類風濕因子分型檢測在類風濕關節炎中的診斷價值研究_《華西醫學》

作者：

嚴莉 , 黃家勤 , 王明權 , 蔡德艷

宜賓市第一人民醫院檢驗科（四川宜賓，644000）;

關鍵詞：

抗環瓜氨酸肽抗體類風濕因子類風濕性關節炎類風濕因子分型診斷效能

DOI：

10.7507/1002-0179.20130589

視頻：

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目的　探討抗環瓜氨酸肽抗體（anti-CCP）與類風濕因子（RF）對類風濕關節炎（RA）的診斷效能，及RF分型檢測在RA活動度判斷中的價值。方法　選取2012年3月－2013年2月就診的64例RA患者為病例組，103例其他自身免疫性疾病患者為對照組，用酶聯免疫吸附試驗分別檢測anti-CCP和RF-IgM/IgG/IgA，收集數據進行統計分析。結果　anti-CCP與RF聯合指標對RA的診斷靈敏度最高（92.2%），anti-CCP的特異度最高（95.1%）；RF-IgA的水平與骨關節侵蝕程度呈正相關（rs=0.987，P=0.000）；RF的3個亞型都可反映RA疾病的活動度（P＜0.05）。結論　anti-CCP與RF聯合診斷RA，可顯著提高診斷靈敏度，RF的分型檢測對于RA患者的活動度監測有重要價值。

引用本文： 嚴莉,黃家勤,王明權,蔡德艷. 抗環瓜氨酸肽抗體和類風濕因子分型檢測在類風濕關節炎中的診斷價值研究. 華西醫學, 2013, 28(12): 1865-1867. doi: 10.7507/1002-0179.20130589 復制

1.	Block DR, Jenkins SM, Dalenberg DA, et al. Analytical and clinical comparison of anti-CCP assays with rheumatoid factor for the diagnosis of rheumatoid arthritis[J]. Clin Chim Acta, 2012, 413 (11-12): 1015-1017.
2.	Chen HA, Lin KC, Chen CH, et al. The effect of etanercept on anti-cyclic citrullinated peptide antibodies and rheumatoid factor in patients with rheumatoid arthritis[J]. Ann Rheum Dis, 2006, 65(1): 35-39.
3.	Arnett FC, Edworthy SM, Bloch DA, et al. The American Rheumatism Association 1987 revised criteria for the classification of rheumatoid arthritis[J]. Arthritis Rheum, 1988, 31(3): 315-324.
4.	中華醫學會風濕病學分會. 類風濕關節炎診斷及治療指南[J]. 中華風濕病學雜志, 2010, 14(4): 265-270.
5.	Taylor P, Gartemann J, Hsieh J, et al. A systematic review of serum biomarkers anti-cyclic citrullinated Peptide and rheumatoid factor as tests for rheumatoid arthritis[J]. Autoimmune Dis, 2011(2011): 815038.
6.	Us D, Gülmez D, Hasçelik G. Cyclic citrullinated peptide antibodies (anti-CCP) together with some other parameters used for serologic diagnosis of rheumatoid arthritis[J]. Mikrobiyol Bul, 2003, 37(2-3): 163-170.
7.	Agrawal S, Misra R, Aggarwal A. Autoantibodies in rheumatoid arthritis: association with severity of disease in established RA[J]. Clin Rheumatol, 2007, 26(2): 201-204.
8.	Hayashi N, Nishimura K, Kumagai S. New biomarkers for rheumatoid arthritis[J]. Rinsho Byori, 2008, 56(4): 297-308.
9.	Heidari B, Firouzjahi A, Heidari P, et al. The prevalence and diagnostic performance of anti-cyclic citrullinated peptide antibody in rheumatoid arthritis: the predictive and discriminative ability of serum antibody level in recognizing rheumatoid arthritis[J]. Ann Saudi Med, 2009, 29(6): 467-470.
10.	Nishimura K, Sugiyama D, Kogata Y, et al. Meta-analysis: diagnostic accuracy of anti-cyclic citrullinated peptide antibody and rheumatoid factor for rheumatoid arthritis[J]. Ann Intern Med, 2007, 146(11): 797-808.
11.	Gao F, Ren L, Zhang CQ, et al. Diagnostic value of anti-cyclic citrullinated peptide antibody for rheumatoid arthritis in a Chinese population: a meta-analysis[J]. Rheumatol Int, 2012, 32(10): 3201-3218.
12.	Eberhardt KB, Truedsson L, Pettersson H, et al. Disease activity and joint damage progression in early rheumatoid arthritis: relation to IgG, IgA, and IgM rheumatoid factor[J]. Ann Rheum Dis, 1990, 49(11): 906-909.
13.	Houssien DA, Jónsson T, Davies E, et al. Rheumatoid factor isotypes, disease activity and the outcome of rheumatoid arthritis: comparative effects of different antigens[J]. Scand J Rheumatol, 1998, 27(1): 46-53.
14.	Ärlestig L, Mullazehi M, Kokkonen H, et al. Antibodies against cyclic citrullinated peptides of IgG, IgA and IgM isotype and rheumatoid factor of IgM and IgA isotype are increased in unaffected members of multicase rheumatoid arthritis families from northern Sweden[J]. Ann Rheum Dis, 2012, 71(6): 825-829.
15.	Hjeltnes G, Hollan I, Førre ?, et al. Anti-CCP and RF IgM: predictors of impaired endothelial function in rheumatoid arthritis patients[J]. Scand J Rheumatol, 2011, 40(6): 422-427.
16.	Newkirk MM, Goldbach-Mansky R, Senior BW, et al. Elevated levels of IgM and IgA antibodies to Proteus mirabilis and IgM antibodies to Escherichia coli are associated with early rheumatoid factor (RF)-positive rheumatoid arthritis[J]. Rheumatology (Oxford), 2005, 44(11): 1433-1441.

1. 　Block DR, Jenkins SM, Dalenberg DA, et al. Analytical and clinical comparison of anti-CCP assays with rheumatoid factor for the diagnosis of rheumatoid arthritis[J]. Clin Chim Acta, 2012, 413 (11-12): 1015-1017.
2. 　Chen HA, Lin KC, Chen CH, et al. The effect of etanercept on anti-cyclic citrullinated peptide antibodies and rheumatoid factor in patients with rheumatoid arthritis[J]. Ann Rheum Dis, 2006, 65(1): 35-39.
3. 　Arnett FC, Edworthy SM, Bloch DA, et al. The American Rheumatism Association 1987 revised criteria for the classification of rheumatoid arthritis[J]. Arthritis Rheum, 1988, 31(3): 315-324.
4. 　中華醫學會風濕病學分會. 類風濕關節炎診斷及治療指南[J]. 中華風濕病學雜志, 2010, 14(4): 265-270.
5. 　Taylor P, Gartemann J, Hsieh J, et al. A systematic review of serum biomarkers anti-cyclic citrullinated Peptide and rheumatoid factor as tests for rheumatoid arthritis[J]. Autoimmune Dis, 2011(2011): 815038.
6. 　Us D, Gülmez D, Hasçelik G. Cyclic citrullinated peptide antibodies (anti-CCP) together with some other parameters used for serologic diagnosis of rheumatoid arthritis[J]. Mikrobiyol Bul, 2003, 37(2-3): 163-170.
7. 　Agrawal S, Misra R, Aggarwal A. Autoantibodies in rheumatoid arthritis: association with severity of disease in established RA[J]. Clin Rheumatol, 2007, 26(2): 201-204.
8. 　Hayashi N, Nishimura K, Kumagai S. New biomarkers for rheumatoid arthritis[J]. Rinsho Byori, 2008, 56(4): 297-308.
9. 　Heidari B, Firouzjahi A, Heidari P, et al. The prevalence and diagnostic performance of anti-cyclic citrullinated peptide antibody in rheumatoid arthritis: the predictive and discriminative ability of serum antibody level in recognizing rheumatoid arthritis[J]. Ann Saudi Med, 2009, 29(6): 467-470.
10. 　Nishimura K, Sugiyama D, Kogata Y, et al. Meta-analysis: diagnostic accuracy of anti-cyclic citrullinated peptide antibody and rheumatoid factor for rheumatoid arthritis[J]. Ann Intern Med, 2007, 146(11): 797-808.
11. 　Gao F, Ren L, Zhang CQ, et al. Diagnostic value of anti-cyclic citrullinated peptide antibody for rheumatoid arthritis in a Chinese population: a meta-analysis[J]. Rheumatol Int, 2012, 32(10): 3201-3218.
12. 　Eberhardt KB, Truedsson L, Pettersson H, et al. Disease activity and joint damage progression in early rheumatoid arthritis: relation to IgG, IgA, and IgM rheumatoid factor[J]. Ann Rheum Dis, 1990, 49(11): 906-909.
13. 　Houssien DA, Jónsson T, Davies E, et al. Rheumatoid factor isotypes, disease activity and the outcome of rheumatoid arthritis: comparative effects of different antigens[J]. Scand J Rheumatol, 1998, 27(1): 46-53.
14. 　Ärlestig L, Mullazehi M, Kokkonen H, et al. Antibodies against cyclic citrullinated peptides of IgG, IgA and IgM isotype and rheumatoid factor of IgM and IgA isotype are increased in unaffected members of multicase rheumatoid arthritis families from northern Sweden[J]. Ann Rheum Dis, 2012, 71(6): 825-829.
15. 　Hjeltnes G, Hollan I, Førre ?, et al. Anti-CCP and RF IgM: predictors of impaired endothelial function in rheumatoid arthritis patients[J]. Scand J Rheumatol, 2011, 40(6): 422-427.
16. 　Newkirk MM, Goldbach-Mansky R, Senior BW, et al. Elevated levels of IgM and IgA antibodies to Proteus mirabilis and IgM antibodies to Escherichia coli are associated with early rheumatoid factor (RF)-positive rheumatoid arthritis[J]. Rheumatology (Oxford), 2005, 44(11): 1433-1441.

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抗環瓜氨酸肽抗體和類風濕因子分型檢測在類風濕關節炎中的診斷價值研究

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