[1]卢春利,刘小玲,曹团平,等.幼年类风湿关节炎患者中抗CCP抗体和RF，AKA，APF的相关性分析[J].现代检验医学杂志,2015,30(06):136-139.[doi:10.3969/j.issn.1671-7414.2015.06.042]
　LU Chun-li,LIU Xiao-ling,CAO Tuan-ping,et al.Analysis on the Correlation of Anti-CCP Antibody and RF，AKA，APF in JRA[J].Journal of Modern Laboratory Medicine,2015,30(06):136-139.[doi:10.3969/j.issn.1671-7414.2015.06.042]
点击复制

幼年类风湿关节炎患者中抗CCP抗体和RF，AKA，APF的相关性分析()
分享到：

《现代检验医学杂志》[ISSN:/CN:]

卷:
第30卷
期数:
2015年06期
页码:
136-139
栏目:
检验与临床
出版日期:
2015-12-30

文章信息/Info

Title:
Analysis on the Correlation of Anti-CCP Antibody and RF，AKA，APF in JRA
作者:
卢春利; 刘小玲; 曹团平; 赵婵媛; 闻苗苗; 尤国栋; 王锐; 刘媛; 赵薇
西安市第五医院检验科，西安710082
Author(s):
LU Chun-li; LIU Xiao-ling; CAO Tuan-ping; ZHAO　Chan-yuan;  WEN Miao-miao; YOU Guo-dong; WANG Rui; LIU Yuan; ZHAO　Wei
Department of Clinical Laboratory，the Fifth Hospital of Xi’an，Xi’an 710082，China
关键词:
幼年类风湿关节炎; 抗环瓜氨酸多肽抗体; 类风湿因子; 抗角蛋白抗体; 抗核周因子
分类号:
R593.22；R392.11
DOI:
10.3969/j.issn.1671-7414.2015.06.042
文献标志码:
A
摘要:
目的探讨幼年类风湿关节炎患者(JRA)血清中类风湿因子(RF)、抗角蛋白抗体(AKA)、抗核周因子(APF)与抗环瓜氨酸多肽(CCP)抗体的相关性。方法收集2012年1月～2013年1月儿童风湿病科门诊及住院确诊的幼年类风湿关节炎(JRA)确诊患者100例，其中男性62例，女性38例，幼年其它风湿病患者69例，健康对照儿童50例血清标本，检测其血清中抗CCP抗体及RF，AKA和APF四种指标，分析抗CCP抗体与RF，AKA和APF的相关性及各项指标联合检测的敏感度和特异度。结果100例JRA组中抗CCP抗体，RF，AKA和APF阳性率分别为48%，25%，28%和34%；69例幼年其它风湿病患者组中阳性率分别为2.89%，4.35%，1.45%和1.45%，50例健康对照组各指标均为阴性。抗CCP抗体在JRA组阳性率与幼年其它风湿病组及健康对照组比较差异有统计学意义(χ2=22.1，43.7，P＜0.001)。在JRA组中，抗CCP抗体，RF，AKA和APF的敏感度分别为48%，25%，28%和34%，特异度分别为98.3%，97.5%，98.8%和98.8%，抗CCP抗体测定对JRA有较高的敏感度和很好的特异度，敏感度与RF，AKA和APF比较差异均有统计学意义(χ2=46.1，38.2，31.7，P＜0.01)，特异度差异无统计学意义(P>0.05)，抗CCP抗体与RF，AKA和APF这三种指标的重叠阳性率分别为21%，24%和31%，结果相符率分别为69%，72%和80%。经Kendalls Tau-b相关性检验分析，结果显示抗CCP抗体与RF，AKA和APF的相关系数分别为r=0.387，0.451和0.401；均P＜0.01，抗CCP抗体与RF，AKA和APF之间均存在相关性。结论抗CCP抗体对JRA有较高的敏感度和很好的特异度，抗CCP抗体与RF，AKA和APF之间存在相关性，抗CCP抗体在RF，AKA和APF均为阴性的JRA中意义重大。各项指标若能联合检测，则可较大提高JRA患者的早期诊断率，可以弥补单项检测造成的误诊或漏诊。
Abstract:
ObjectiveTo discuss the correlation of rheumatoid factors (RF)，anti-keratin antibody (AKA)，anti-perinuclear factors (APF)，anti-cyclic citrullinated peptide (CCP) antibody in the serum of juvenile rheumatoid arthritis (JRA) patients．MethodsTested anti-CCP antibody，RF，AKA，and APF in the serum of 100 JRA patients，69 other juvenile rheumatoid patients and 50 healthy control children，compared the correlation of anti-CCP antibody and RF，AKA and APF，as well as the sensitivity and specificity of joint detection of other indexes．ResultsIn 100 JRA patients，the positive rate of anti-CCP antibody，RF，AKA and APF was 48%，25%，28% and 34% respectively．In 69 other juvenile rheumatoid patients，the positive rate of anti-CCP antibody，RF，AKA and APF was 2.89%，4.35%，1.45% and 1.45% respectively．In 50 healthy control children，all indexes were positive．The comparative difference of positive rate of anti-CCP antibody in JRA group，other juvenile rheumatoid patients group，and healthy control group had great statistical significance (χ2=22.1，43.7，P＜0.001)．In JRA group，the sensitivity of anti-CCP antibody，RF，AKA and APF were separately 48%，25%，28% and 34%，and the specificity were separately 98.3%，97.5%，98.8% and 98.8%．The detection of anti-CCP antibody had high sensitivity and good specificity on JRA．Compared with RF，AKA and APF，the sensitivity of anti-CCP antibody had significant difference (χ2=46.1，38.2 and 31.7，all P＜0.01)，the difference on specificity had no statistical significance (P>0.05)．The overlapping positive rate of anti-CCP antibody and RF，AKA and APF，were separately 21%，24% and 31%，and corresponding rate of the results were separately 69%，72% and 80%．According to the correlation test in Kendall’s Tau-b method，the correlation coefficient of anti-CCP antibody and RF，AKA and APF were separately (r=0.387，0.451，0.401；all P＜0.01)，and there was correlation between anti-CCP antibody and RF，AKA and APF．ConclusionAnti-CCP antibody had high sensitivity and good specificity on JRA．Anti-CCP antibody had great significance in JRA with negative RF，AKA and APF．The joint detection of these indexes can greatly increase the early diagnostic rate of JRA patients and avoid misdiagnosis or missed diagnosis of single index detection．

参考文献/References:

［1］Quinn AK，Gough AK，Green MJ，et al．Anti -CCP antibodies measured at disease onset help identify seronegative rheumatoid arthritis and predict radiological and functional outcome［J］．Rheumatology(Oxford),2006，45(4)：478-480．
[2]Albert ED，Scholz S．Juvenilearthritis：genetic update［J］．Bailliere’s Clin Rheumatol，1998，12(2)：209-218．
[3]Murray KJ，Moroldo MB，Donnelly P，et al．Agespecific effects of juvenile rheumatoid arthritis-associate HLA alleles［J］．Arthritis Rheum，1999，42(9)：1843-1853．
[4]Phelan JD，Thompson SD．Genomic progress in pediatric arthritis：recent work and future goals［J］．Current Opinion in Rheumatology，2006，18(5)：482-489．
[5]腾庆，刘永革，何晓琥．抗环瓜氨酸肽抗体和隐匿性类风湿因子免疫球蛋白M型在诊断幼年类风湿关节炎中的意义［J］．实用儿科临床杂志，2004，19(10)：845-847． Teng Q，Liu YG，He XH．Diagnostic significance of combined testing of anti-cyclic citrullinated peptide antibody and hidden rheumatoid factor immunoglobulin M in protein with juvenile rheumatoid arthritis［J］．Journal of Applied Clinical Pediatrics，2004，19(10)：845-847．
[6]Schubert D，Maier B，Morawietz L，et al．Immunization with glucose-6-phosphate isomerase induces T cell-dependent peripheral polyarthritis in genetically unaltered mice［J］．J Immunol，2004，172(7)：4503-4509．
[7]赵冠飞，李永哲．葡萄糖6-磷酸异构酶与类风湿关节炎研究进展［J］．中华风湿病学杂志，2007，11(12)：750-754． Zhao GF，Li YZ．Progress of glucose 6-phosphate isomerase and rheumatoid arthritis research［J］．Chinese Journal of Rheumatology，2007，11(12)：750-754．
[8]茹晋丽，李小峰，张莉芸，等．抗瓜氨酸肽抗体谱在幼年类风湿关节炎诊断中的意义［J］．中华风湿病学杂志，2007，11(4)：239-241． Ru JL，Li XF，Zhang LY，et al．Diagnostic significance of detection of anti-citrullinated peptide antibodies in Juvenile rheumatoid arthritis［J］．Chinese Journal of Rheumatology，2007，11(4)：239-241．
[9]Klareskog L，Ronnelid J，Lundberg K，et al．Immunity to citrullinated proteins in rheumatoid arthritis［J］．Annu Rev Immunol，2008，26(1)：651-675．
[10]刘国瑞，常林，郑田，等．两种方法检测血清抗CCP抗体在RA诊断中的比较［J］．现代检验医学杂志，2014，29(1)：83-84． Liu GR，Chang L，Zheng T，et al．Comparison of two methods for the detection of serum anti CCP antibody in the diagnosis of RA［J］．Journal of Modern Laboratory Medicine，2014，29(1)：83-84．
[11]刘彦红，卢秀敏，高飞．类风湿关节炎自身抗体类风湿因子与抗瓜氨酸化蛋白抗体关系的研究进展［J］．国际检验医学杂志，2011，32(9)：973-975． Liu YH，Lu XM，Gao F．The Study on the Relationship between Autoantibody Rheumatoid Factors of Rheumatoid Arthritis and Anticitrullinated ProteinAntibodies［J］．International Journal of Laboratory Medicine，2011，32(9)：973-975．

相似文献/References:

[1]陈建芸a,廖海平a,孙朝晖a,等.类风湿性关节炎患者血清RA-CP，抗CCP 抗体及RF 检测对RA 的实验诊断意义[J].现代检验医学杂志,2020,35(05):38.[doi:10.3969/j.issn.1671-7414.2020.05.010]
　CHEN Jian-yuna,LIAO Hai-pinga,SUN Zhao-huia,et al.Significance of the Detection of RA-CP, Anti-CCP Antibody and RF in the Laboratory Diagnosis of Rheumatoid Arthritis[J].Journal of Modern Laboratory Medicine,2020,35(06):38.[doi:10.3969/j.issn.1671-7414.2020.05.010]

备注/Memo

备注/Memo:
基金项目：西安市卫计委，项目编号：J2011013，抗CCP抗体在幼年类风湿关节炎中的诊断价值分析。 作者简介：卢春利(1969-)，女，本科，副主任技师，研究方向：风湿病免疫，Tel：13991379081，E-mail：lsl6702@126.com。 刘小玲(1963-)，女，本科，主任技师，研究方向：风湿病免疫，Tel：18991900936，E-mail：lxl0504@126.com，同为第一作者。
更新日期/Last Update: 1900-01-01