| 杨珂珂 徐玉梅 郑洁 陆咏 张安.抗CCP 抗体对老年起病类风湿关节炎诊断及预后评估的临床价值[J].,2014,14(13):2480-2483 |
| 抗CCP 抗体对老年起病类风湿关节炎诊断及预后评估的临床价值 |
| Clinical value of the anti-cyclic Citrullinated peptide Antibody in thediagnosis and Prognosis Evaluation of elderly-onset Rheumatoid Arthritis |
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| DOI： |
| 中文关键词: 老年起病类风湿关节炎 抗环瓜氨酸肽抗体 类风湿因子 诊断 预后 |
| 英文关键词: Elderly-onset rheumatoid arthritis Anti-cyclic citrullinated peptide antibodies Rheumatoid factor Diagnosis Prognosis |
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| 中文摘要: |
| 目的：探讨抗环瓜氨酸肽(CCP)抗体对老年起病类风湿关节炎(EORA)诊断和预后评估的临床应用价值。方法：收集2010 年
3 月至2011 年3 月在上海市第一人民医院分院风湿科门诊及住院治疗的EORA 患者98 例，骨性关节炎(OA)患者30 例，风湿性
多肌痛(PMA)患者10 例，其他结缔组织病30 例，正常老年健康对照48 例，应用酶联免疫吸附法检测所有患者血清抗CCP 抗体
水平，并检测其IgM型类风湿因子(IgM-RF)。计算抗CCP抗体、IgM-RF及联合检测两者诊断EORA 的特异度、敏感度、阳性预测
值、阴性预测值。同时记录EORA 患者的临床资料，分析抗CCP 抗体阴性和阳性患者中年龄、性别、疾病活动指数28(DAS28)、
ESR、CRP、骨损害的变化，对其预后进行预测。结果：EORA 患者抗CCP 抗体和IgM-RF的阳性率均明显高于其他结缔组织病患
者和健康对照人群，差异均有统计学意义(P<0.05)。抗CCP 抗体对EORA 诊断的敏感性略低于IgM-RF，但特异性明显提高，差异
均有统计学意义(P<0.05)。抗CCP 抗体及IgM-RF对EORA 诊断的敏感性和特异性分别为：61.2%、75.5%和97.1%、62.9%，两者联
合检测的敏感性及特异性为：49%和98.5%。差异均有统计学意义(P<0.05)。抗CCP 抗体阳性患者和阴性患者比较，年龄、性别、病
程、ESR、CRP水平的差异均无统计学意义(P>0.05)，但抗CCP 抗体水平与DAS28 评分呈正相关(P<0.05)，与关节x 线分期无明显
相关性(P>0.05)。但抗CCP 抗体阳性患者，更易出现骨损害，预后较差。结论：抗CCP抗体对诊断EORA 具有较高的临床价值，且
可以作为辅助预测和评价预后的指标。 |
| 英文摘要: |
| Objective:To determine the clinical value of the anti-cyclic citrullinated peptide antibody (CCP) in the diagnosis and
prognosis evaluation of elderly-onset rheumatoid arthritis (EORA).Method:A total of 98 patients with EORA, 30 patients with
Osteoarthritis(OA), 10 patients with Polymyalgia rheumatica (PMA) and 30 patients with other connective tissue disease were recruited
in this study. Anti-CCP antibodies and IgM-rheumatoid factor were determined by ELISA according to manufacturer instructions, with a
cut-off of 20u, The anti-CCP antibodies and erythrocyte sedimentation rate (ESR), C reactive protein (CRP), activity score 28(DAS28)
and bone erosion was Assessed.Results:In the group of patients with EORA, the sensitivity and specificity of anti-ccp antibodies and
IgM-RF were respectively 61.2%,75.5%and 97.1%,62.9%. The sensitivity and specificity of united-detection of anti-ccp antibodies and
IgM-RF were 49% and 97.1%.The mean DAS28 score of EORA patients with anti-CCP positive was significantly higher than that of
patients without anti-CCP. Among anti-CCP positive EORA patients, the mumber of patients with erosion disease was signficantly higher
than the patients without anti-CCP and with worse prognosis.Conclusion:Anti-CCP antibodies was a higher specific autoantibody in the
diagnosis of EORA and could be used as a prognostic indicator of prediction and evaluation of EORA. |
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