【摘要】 目的比较葡萄糖-6-磷酸异构酶(glucose-6-phosphate isome-rase,GPI)和抗环瓜氨酸肽(anti-cycliccitrullinated peptide,anti-CCP)抗体对类风湿关节炎(rheumatoid arthritis,RA)的诊断意义。方法收集未经治疗的128例RA患者(RA组)、117例其他风湿病人(非RA组)、74例健康人(正常对照组)血清,采用酶联免疫吸附法(ELISA)检测GPI、抗CCP抗体,采用速率散射比浊法检测RF、C反应蛋白(CRP)、补体(C3、C4)、免疫球蛋白(IgA、IgG、IgM),采用魏氏法测红细胞沉降率(血沉,ESR)。结果⑴GPI、抗CCP抗体诊断RA的特异性(分别为91.09%、94.14%)、敏感性(分别为75.0%、75.8%)差异均无统计学意义(P>0.05),但二者特异性与RF(78.53%)比差异有统计学意义(P<0.01)。⑵GPI、抗CCP抗体分别与RF联合检测,两个指标均为阳性诊断RA的特异性(分别为94.24%、95.81%)差异无统计学意义(P>0.05),与单独检测RF比差异有统计学意义(P<0.01);两个指标任一阳性诊断RA的敏感性(分别为85.16%、85.94%)差异无统计学意义(P>0.05),与单独检测GPI或抗CCP抗体比差异有统计学意义(P<0.05)。⑶GPI阳性的RA患者关节炎部位数、CRP、ESR水平明显高于GPI阴性RA患者,且差异有统计学意义(P<0.05)。结论 GPI诊断RA具有与抗CCP抗体相似的特异性和敏感性。与RF联合检测可提高诊断RA的特异性和敏感性。此外,GPI还可作为RA活动性指标。更多还原

【Abstract】 Objective To compare the diagnostic values of glucose-6-phosphate isomerase(GPI) and anti-cyclic citrullinated peptide(anti-CCP) antibodies for the patients with rheumatoid arthritis(RA). Methods Serum GPI and anti-CCP antibody levels were detected by enzyme-linked immunosorbent assays(ELISAs) in 128 patients with rheumatoid arthritis(RA group),117 other rheumatic diseases(non-RA group),and 74 healthy subjects(normal control group).Rheumatoid factor(RF),C-reactive protein(CRP),complement 3(C3),complement 4(C4),immunoglobulin A(IgA),immunoglobulin G(IgG),and immuno-globulin M(IgM) were examined with rate scatter nephelometry.Erythrocyte sedimentation rate(ESR) was determined by Westergren method. Results Comparing with anti-CCP(94.14%,75.8%),the specificity and the sensitivity of GPI(91.09%,75.0%) had no statistical significance(P>0.05).Comparing with RF(78.53%),the specificity of GPI increased significantly(P<0.01).Comparing with anti-CCP and RF(95.81%),the specificity of GPI and RF(94.24%) had no statistical significance(P>0.05) when both indexes were positive simultaneously.When either index was positive,the same as the sensitivity of the two groups(85.16% and 85.94%,respectively).The GPI positive group had higher levels with arthritis parts,ESR,CRP than the GPI negative group in the patients of RA,and the difference was statistically significant(P<0.05). Conclusions The specificity and sensitivity of GPI were as high as those of anti-CCP in diagnosis of RA.Both sensitivity and specificity of detection were improved when the combined detection of GPI and RF or anti-CCP and RF for the patients with RA.In addition,GPI was one of the rheumatoid activity markers.更多还原