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检测抗突变型瓜氨酸波形蛋白、抗环瓜氨酸肽、红细胞分布宽度和 25-羟维生素 D 在类风湿关节炎诊断中的临床价值。

Clinical Value of Detecting Anti-Mutated Citrullinated Vimentin, Anti-Cyclic Citrullinated Peptide, Red Cell Distribution Width and 25-Hydroxyvitamin D in the Diagnosis of Rheumatoid Arthritis.

机构信息

Department of Clinical Laboratory, the Second Affiliated Hospital of Nanchang University, Jiangxi Province Key Laboratory of Laboratory Medicine.

School of Public Health, Nanchang University, Nanchang, China.

出版信息

Lab Med. 2021 Jan 4;52(1):80-85. doi: 10.1093/labmed/lmaa040.

Abstract

OBJECTIVES

To investigate the clinical value of detecting anti-mutated citrullinated vimentin (anti-MCV), anti-citrullinated peptide (anti-CCP), red-blood-cell distribution width (RDW), and 25-hydroxyvitamin D (25-[OH]D) in the diagnosis of rheumatoid arthritis (RA).

METHODS

We enrolled 119 patients with RA, 114 control individuals without RA (disease controls), and 40 healthy controls in our study (Han Chinese). Anti-CCP and anti-MCV were detected by enzyme-linked immunosorbent assay (ELISA), 25-(OH)D was detected by electrochemical luminescence, and RDW was calculated by erythrocyte parameters detected via the electric resistance method.

RESULTS

The serum levels of anti-CCP and anti-MCV in RA were higher than those in disease controls and healthy controls (P <.01). The areas under the curve (AUCs) of anti-MCV, anti-CCP, RDW, and 25-(OH)D were 0.857, 0.890, 0.611, and 0.569 respectively (P <.05). In various combinations of indicators, when RDW, 25-(OH)D, and anti-CCP; or RDW, 25-(OH)D, anti-CCP, and anti-MCV were connected in parallel, the sensitivity was the highest (all 94.1%). Also, when RDW, 25-(OH)D, anti-CCP, and anti-MCV were connected in series, the sensitivity was the lowest (13.4%).

CONCLUSIONS

Anti-CCP and anti-MCV are ideal indices for RA diagnosis. Also, in combination with RDW and 25-(OH)D, the diagnostic level will be improved, as well as the sensitivity and specificity, which is significant for the differential diagnosis of RA.

摘要

目的

探讨抗突变型瓜氨酸波形蛋白(anti-MCV)、抗环瓜氨酸肽(anti-CCP)、红细胞分布宽度(RDW)和 25-羟维生素 D(25-(OH)D)检测在类风湿关节炎(RA)诊断中的临床价值。

方法

纳入了 119 例 RA 患者、114 例无 RA 的疾病对照者和 40 例健康对照者(汉族人)。采用酶联免疫吸附试验(ELISA)检测抗-CCP 和抗-MCV,电化学发光法检测 25-(OH)D,通过电阻法检测红细胞参数计算 RDW。

结果

RA 患者血清抗-CCP 和抗-MCV 水平高于疾病对照者和健康对照者(P<0.01)。抗-MCV、抗-CCP、RDW 和 25-(OH)D 的曲线下面积(AUCs)分别为 0.857、0.890、0.611 和 0.569(P<0.05)。在各种指标组合中,当 RDW、25-(OH)D 和抗-CCP 并联;或 RDW、25-(OH)D、抗-CCP 和抗-MCV 串联时,敏感性最高(均为 94.1%)。而当 RDW、25-(OH)D、抗-CCP 和抗-MCV 串联时,敏感性最低(13.4%)。

结论

抗-CCP 和抗-MCV 是 RA 诊断的理想指标。同时,与 RDW 和 25-(OH)D 联合应用,可提高诊断水平及敏感性和特异性,对 RA 的鉴别诊断具有重要意义。

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