标题：早期类风湿关节炎患者血清抗CCP抗体水平的变化及其诊断价值

      作者：王蓉辉 1，马丽辉 2
    (三亚市人民医院中西医内科 1、血液风湿免疫科 2，海南 三亚 572000）

      卷次： 2015年26卷14期

      【摘要】 目的 探讨抗环瓜氨酸抗体(抗CCP抗体)在早期类风湿关节炎(RA)患者中的水平变化及其在诊
断中的应用价值。方法 选取 2012年 6月至 2014年 5月在我院就诊的早期RA患者 109例(RA组)，同时选取
其他风湿病患者 92例(非RA组)和健康体检者 80例(健康组)，采用酶联免疫吸附试验(ELISA)法检测三组受试
者的抗CCP抗体水平。结果 RA组血清抗CCP抗体水平为(21.27±10.32) IU/ml，明显高于非RA组和健康
组，差异均有统计学意义(P<0.05)，而非RA组和健康组血清抗CCP抗体水平比较差异则无统计学意义(P>
0.05)；抗CCP抗体诊断的灵敏度为 66.97%，特异度为 84.30%，阳性预测值为 73.00%，阴性预测值为 80.11%，约
登指数 0.513；抗CCP抗体诊断RA的受试者工作特征(ROC)曲线，其AUC=0.886，95%置信区间 0.837~0.934，
抗CCP抗体诊断RA最佳界值为 17.5 IU/ml。结论 在RA患者中抗CCP抗体水平较高，抗CCP抗体检测对
RA早期诊断有较高的价值。

      【关键词】 类风湿关节炎；抗环瓜氨酸抗体；诊断

      【中图分类号】 R593.22 【文献标识码】 A 【文章编号】 1003—6350（2015）14—2056—03


Analysis of change in serum anti-CCP antibody level and its diagnostic value in patients of early rheumatoid
arthritis.
WANG Rong-hui 1, MA Li-hui 2. Department of Internal Medicine in TCM and Western Medicine 1, Department
of Blood, Immunology, Rheumatology 2, the People's Hospital of Sanya City, Sanya 572000, Hainan, CHINA

【Abstract】 Objective To investigate the change in serum anti-cyclic citrullinated peptide (anti-CCP) anti-
body level and its diagnostic value in patients of early rheumatoid arthritis (RA). Methods One hundred and
nine patients with early rheumatoid arthritis (RA group) in our hospital from June 2012 to May 2014, 92 patients
without rheumatoid arthritis (non-RA group) and 80 healthy subjects (healthy group) were enrolled in the study.
Enzyme-linked immunosorbent assay (ELISA) was used to test the anti-CCP antibody level in the three groups.
Results Serum anti-CCP antibody level of RA group was (21.27±10.32) IU/ml, significantly higher than that of
non-RA group and the healthy group, and the differences were statistically significant (P<0.05). There was no statis-
tically significant difference in serum anti-CCP antibody level between non-RA group and healthy group (P>0.05).
The sensitivity of anti-CCP antibody diagnosis was 66.97%, and specificity was 84.30%, with the positive predic-
tive value (+PV) of 73%, the negative predictive value (-PV) of 80.11%, and Youden index of 0.513. The receiver
operating characteristic (ROC) curve for anti-CCP antibody in the diagnosis of RA was produced, with AUC=
0.886, 95% confidence interval of (0.837~0.934), and the best bound value of 17.5 IU/ml. Conclusion Anti-CCP
antibody levels are higher in RA patients, and anti-CCP antibody detection has a higher value in the early diagnosis
of RA.

      【Key words】 Rheumatoid arthritis (RA); Anti-cyclic citrullinated peptide antibodies; Diagnosis