【摘要】 目的探讨抗环瓜氨酸肽抗体(抗CCP)、类风湿因子(RF)和超敏C反应蛋白(hs-CRP)联合检测在类风湿关节炎(RA)诊疗中的临床价值。方法以53例RA患者、30例非RA患者和25例健康者为研究对象,检测并比较血清抗CCP、RF和hs-CRP水平和阳性率;采用四格表计算抗CCP、RF和hs-CRP不同组合结果的诊断效率。结果 RA患者血清3项指标检测水平和阳性率均显著高于非RA患者和健康者(P<0.01)。RA患者血清抗CCP、RF和hs-CRP阳性率分别为84.9%、86.8%和81.1%,非RA患者血清RF和hs-CRP阳性率分别为23.3%和36.7%。3项指标单独检测对RA的诊断性能的优势依次为抗CCP、RF、hs-CRP;抗CCP和RF联合检测的敏感性、特异性和诊断符合率分别为92.5%、81.1%和87.0%;三者联合检测的敏感性、阴性预报率和诊断符合率分别为94.3%、93.3%和85.2%。结论检测抗CCP诊断RA具有较高的敏感性和特异性,RF和hs-CRP特异性较差;抗CCP和RF联合检测可作为RA患者的筛查指标,有利于早期诊断,hs-CRP对RA病情严重程度的判断及指导治疗具有重要临床价值。更多还原

【Abstract】 Objective To investigate the clinical value of combined detection of anti-cyclic citrullinated peptide antibodies(anti-CCP),rheumatoid factor(RF) and high-sensitivity C-reactive protein(hs-CRP) for the diagnosis and treatment of rheumatoid arthritis(RA).Methods Serum concentration and positive rate of anti-CCP,RF and hs-CRP were detected and compared in 53 cases of patients with RA,30 cases of patients without RA and 25 cases of healthy controls.Diagnosis efficiency were calculated by matrix decision method.Results Serum level and positive rate of the three detected indicators were significantly elevated in patients with RA,compared with in patients without RA and in healthy controls(P<0.01).The positive rates of anti-CCP,RF and hs-CRP in patients with RA were 84.9%,86.8% and 81.1%,respectively,while in patient without RA,the positive rates of RF and hs-CRP were 23.3% and 36.7%.The diagnosis efficiency of single detection of anti-CCP was the highest among all of the three indicators,and that of hs-CRP was the lowest.The sensitivity,specificity and accuracy of combined determination of anti-CCP and RF were 92.5%,81.1% and 87.0%,and the sensitivity,negative prediction rate and accuracy of combined determination of anti-CCP,RF and hc-CRP were 94.3%,93.3% and 85.2%.Conclusion Anti-CCP might be relatively more sensitive and specific for the diagnosis of RA,compared with RF and hs-CRP.Combined detection of anti-CCP and RF could be usded for screening of patients with RA,and could be helpful for early diagnosis of RA.hs-CRP might have important significance for judgment of disease severity and treatment in patients with RA.更多还原