摘要
目的:评估磁微粒化学发光法检测类风湿关节炎(RA)相关自身抗体的临床诊断价值。方法:回顾性分析重庆市巴南区人民医院2021年9月至2022年3月门诊和住院送检的RA五项(anti-RA33、anti-CCP、RF、RF-IgM、RF-IgG),包括105例RA患者和71例疾病对照组,所有项目均采用吖啶酯磁微粒化学发光法检测。采用ROC曲线分析各检测指标对RA的诊断价值,Spearman相关分析检测变量间的相关性。结果:RA组血清anti-CCP、RF、RF-IgG、RF-IgM水平显著高于对照组(P<0.05),而两组anti-RA33差异无统计学意义(P>0.05);anti-CCP对RA诊断阴性预测值、阳性预测值、约登指数最高,anti-RA33对RA诊断的灵敏度最低,但特异度最高;RF-IgG对RA诊断灵敏度最高。ROC曲线分析显示anti-RA33、anti-CCP、RF、RF-IgG、RF-IgM的AUC分别为0.520、0.870、0.816、0.853、0.848。Spearman相关分析显示anti-CCP、RF、RF-IgG、RF-IgM之间显著相关(P<0.05),而anti-RA33与这4项指标无明显相关性(P>0.05)。结论:ani-RA33灵敏度过低,初筛检测anti-RA33容易漏诊,RF、RF-IgG、RF-IgM对RA具有重要的诊断价值,可用于RA疾病初筛检测。Anti-CCP仍然是5种自身抗体诊断准确性最高的自身抗体,可用于RA的初筛和确诊。
Objective:To evaluate the clinical diagnostic value of rheumatoid arthritis(RA)related autoantibodies based on magnetic particle chemiluminescence examination.Methods:RA related autoantibodies(anti-RA33,anti-CCP,RF,RF-IgM and RFIgG)detected in People's Hospital of Chongqing Banan District from September 2021 to March 2022 were analyzed retrospectively,including 105 patients with RA and 71 disease control groups.All autoantibodies were detected by acridine ester magnetic particle chemiluminescence method.ROC curve was used to analyze diagnostic value of each test index for RA,and Spearman correlation analysis was used to analyze correlation between the test variables.Results:Serum levels of anti-CCP,RF,RF-IgG and RF-IgM in RA group were significantly higher than those in control group(P<0.05),while there was no significant difference in anti-RA33 between two groups(P>0.05);anti-CCP had the highest negative predictive value,positive predictive value and Youden index as diagnosis of RA,and anti-RA33 had the lowest sensitivity but the highest specificity as diagnosis of RA;RF-IgG has the highest sensitivity in diagnosis of RA.ROC curve analysis showed that AUC of anti-RA33,anti CCP,RF,RF-IgG and RF-IgM were 0.520,0.870,0.816,0.853 and 0.848,respectively.Spearman correlation analysis showed that there was a significant correlation among anti-CCP,RF,RF-IgG and RF-IgM(P<0.05),while there was no significant correlation between anti-RA33 and these four indexes(P>0.05).Conclusion:Sensitivity of ani-RA33 is too low,hence it is easy to escape diagnosis or be misdiagnosed as preliminary screening test.RF,RF-IgG and RF-IgM had important diagnostic value for RA and can be used for the preliminary screening test of RA diseases.Anti-CCP is still the autoantibody with the highest diagnostic accuracy in the five autoantibodies,which can be used for the preliminary screening and confirmatory of RA.
作者
荀春华
江代红
瞿俊
XUN Chunhua;JIANG Daihong;QU Jun(Clinical Laboratory of People's Hospital of Chongqing Banan District,Chongqing 400055,China)
出处
《中国免疫学杂志》
CAS
CSCD
北大核心
2023年第11期2393-2396,共4页
Chinese Journal of Immunology
基金
重庆市自然科学基金面上项目(cstc2020jcyj-msxmX0490)。
