抗RA33抗体、RF、CRP、ANA与ENA联合检测在类风湿性关节炎患者诊断、治疗及预后中的作用

目的：探讨血清抗RA33抗体、RF、CRP联合检测在类风湿性关节炎患者诊断、治疗及预后中的作用。方法：采用ELISA法对35例类风湿性关节炎患者和30例健康对照者进行抗RA33抗体的检测，间接免疫荧光法检测ANA、免疫印迹法检测ENA，免疫比浊法进行类风湿因子（RF）及CRP的检测。结果：类风湿性关节炎患者组RF水平为：（104．51±153．88）KIU／L]与健康对照组（10．89±2．78）KIU／L]比较，差异非常显著（p〈0．01）；类风湿性关节炎组CRP（11．60±23．24）mg／L]与健康对照组（2．57±2．18）mg／L]比较，差异显著（p〈0．05）；类风湿性关节炎组抗RA33抗体水平：（17．81±35．11）U／mL]与健康对照组（8．10±8．40）U／mL]比较，差异非常显著（p〈0．01）。RF、抗RA33抗体、CRP及ANA诊断类风湿性关节炎的灵敏度分别为：80．00％，34．29％，42．86％，62．86％；RF、抗RA33抗体、CRP及ANA诊断类风湿性关节炎的特异性分别为：93.33％，93.33％，90．00％，96．67％；ENA的检出率均较低。结论：类风湿性关节炎患者抗RA33抗体检出的灵敏度低，但特异性强。对类风湿性关节炎患者进行抗RA33抗体、ANA、RF、CRP、ENA联合检测，对于疾病的进展、病因分析、指导治疗和改善预后均具有重要意义。

Clinical Significance of Combined Detection of RF, Anti-RA33 antibody, CRP, ANA with ENA in Diagnosis, Treatment and Predicting Procession of Rheumatoid Arthritis

Objective： To explore the clinical significance of combined detection of RF, Anti-RA33 antibody, CRP, ANA with ENA in diagnosis, treatment and predicting procession of rheumatoid arthritis （RA）. Methods： The level of serum Anti-RA33 antibody was detected by using double antibody sandwich ELISA in 35 patients with rheumatoid arthritis （RA） and 30 healthy people. The serum C-reactive protein（CRP）and rheumatoid factor（RF）levels were measured by the immune nephelometry. Antinuclear antibodies were measured by indirect immunofluorescence technique and immunoblotting was applied to detecting ant-ENA antibodies. Results： The level of RF between RA group （104.51± 153.88）KIU/L] and healthy control group （10.89±2.78）KIU/L] was significantly different（p〈0.01）. The level of CRP in patients with RA （11.60± 23.24）mg/L], compared with healthy control group （2.57±2.18）mg/L], has remarkable difference （p〈0.05）. The level of Anti-RA33 antibody in patients with RA （17.81 ± 35.11）U/mL] also has significantly difference （p〈0. 01） when compared with healthy control group （8.10± 8.40）U/roLl. The sensitivities of the four （RF, Anti-RA33 antibody, CRP, ANA） to RA were 80.00%, 34.29%, 42.86% and 62.86%, respectively; while the specificity were 93.33%, 93.33%, 90.00% and 96.67%, respectively. The positive rates of ENA were lower in each group. Conclusion： Anti-RA33 antibody has lower sensitivity, but higher specificity to RA. Combined detection ofRF, Anti-RA33 antibody, CRP, ANA with ENA is helpful in diagnosis and treatment of RA.