类风湿关节炎中抗环瓜氨酸化肽抗体

[Antibodies to cyclic citrullinized peptide in rheumatoid arthritis].

作者信息

Aleksandrova E N, Chemeris N A, Karateev D E, Novikov A A, Brodetskaia K A, Nasonov E L

出版信息

Ter Arkh. 2004;76(12):64-8.

PMID:15724930

Abstract

AIM

To estimate a diagnostic value of antibodies to cyclic citrullinized peptide (CCP) in rheumatoid arthritis (RA).

MATERIAL AND METHODS

The study was made of 85 RA patients. Of them, 48 patients had early RA, i.e. of 8 month and less duration. The control group consisted of 35 patients with non-differentiated arthritis (NDA) and 8 healthy donors. Concentrations of CCP antibodies, rheumatoid factor (RF) IgM and RF IgA were measured with enzyme immunoassay (EIA).

RESULTS

The level of CCP antibodies in RA patients (76.3 +/- 43.8; median 100.0 U/ml) was significantly higher than in NDA patients (25.1 +/- 43.9; median 0.8 U/ml; p < 0.05) or in donors (0.38 +/- 0.36; median 0.2 U/ml; p < 0.05). A correlation was found between the CCP antibodies level and that of RF IgM (chi2 = 15.4; p = 0.001) and RF IgA (chi2 = 10.3; p = 0.001). Sensitivity (82%) and specificity (90%) of CCP antibodies in RA diagnosis was higher than these parameters for RF IgM and IgA (78%, 86% and 72%, 83%, respectively). Simultaneous tests for CCP antibodies, RF IgM and RF IgA led to a 93% specificity. CCP antibodies were detected in 50% patients seronegative by RF IgM and in 62% patients seronegative by IgA. Detection of CCP antibodies was closely associated with early RA (chi2 = 30.8; p = 0.0001).

CONCLUSION

The EIA for CCP antibodies is a sensitive and specific serological test for early RA diagnosis.

摘要

目的

评估抗环瓜氨酸肽（CCP）抗体在类风湿关节炎（RA）中的诊断价值。

材料与方法

对85例RA患者进行研究。其中，48例为早期RA，即病程8个月及以内。对照组由35例未分化关节炎（NDA）患者和8例健康供者组成。采用酶免疫分析法（EIA）检测CCP抗体、类风湿因子（RF）IgM和RF IgA的浓度。

结果

RA患者的CCP抗体水平（76.3±43.8；中位数100.0 U/ml）显著高于NDA患者（25.1±43.9；中位数0.8 U/ml；p<0.05）或供者（0.38±0.36；中位数0.2 U/ml；p<0.05）。发现CCP抗体水平与RF IgM水平（χ²=15.4；p=0.001）和RF IgA水平（χ²=10.3；p=0.001）之间存在相关性。RA诊断中CCP抗体的敏感性（82%）和特异性（90%）高于RF IgM和IgA的这些参数（分别为78%、86%和72%、83%）。同时检测CCP抗体、RF IgM和RF IgA的特异性为93%。在RF IgM血清阴性的患者中，50%检测到CCP抗体；在IgA血清阴性的患者中，62%检测到CCP抗体。CCP抗体的检测与早期RA密切相关（χ²=30.8；p=0.0001）。