血清14-3-3η、DD、anti-CCP 及CRP 检测 对鉴别诊断RA 的临床意义

Significance of serum 14-3-3η, D-dimer, anti-CCP and CRP in diagnosis of RA

摘要:

目的 探讨14-3-3η 蛋白、D- 二聚体（DD）、抗环瓜氨酸多肽抗体（anti-CCP）及C 反 应蛋白（CRP）联合检测对类风湿关节炎（RA）鉴别诊断的临床意义。方法 采用ELISA 法检测3 组患 者的14-3-3η 蛋白、anti-CCP，胶乳免疫比浊法检测DD，速率散射比浊法检测CRP，比较分析各检测指 标对RA 鉴别诊断的价值。结果 RA 组血清各指标和指标阳性率均显著高于其他风湿性疾病组和对照组 （P <0.05）；14-3-3η 蛋白、DD 和anti-CCP 的ROC 曲线下面积分别为0.971、0.779 及0.863（P <0.05）， 对诊断RA 准确性较高；DD 和anti-CCP 并联时敏感性最高，为97.68%，DD 和anti-CCP 串联时特异性最高， 为99.42%。结论 14-3-3η 蛋白、DD 水平在RA 患者中显著升高，是诊断RA 的理想指标，DD 和anti- CCP 联合检测对鉴别诊断RA 有较大价值。

Abstract:

Objective To explore the significance of detecting serum D-dimer, 14-3-3η protein, anti-CCP and CRP in diagnosis of rheumatoid arthritis (RA). Methods Serum samples of 64 RA patients, 155 non-RA patients and 40 healthy controls from the Second Affiliated Hospital of Nanchang University were collected. The levels of 14-3-3η protein and anti-CCP were measured by enzyme linked immunosorbent assay. D-dimer was detected with latex immunoturbidimetric assay. And CRP was determined by rate nephelometry (RN). The levels of the indicators and their diagnostic utilities were evaluated and compared then. Results Serum levels of D-dimer, 14-3-3η, anti- CCP and CRP in the RA group were remarkably higher than those in the non-RA group and the healthy group, the differences among groups were statistically significant (P < 0.05); so were the positive rates (P < 0.05).According to the ROC curve based on the serum levels detected, the AUC of 14-3-3η protein, D-dimer and anti-CCP were 0.971, 0.779 and 0.863 respectively (P < 0.05), which had high accuracy for RA diagnosis. The combination of D-dimer and anti-CCP had the highest sensitivity of 97.68%, and the highest specificity of 99.42%. Conclusions Serum 14-3-3η protein and D-dimer levels remarkably increase in RA patients, and are ideal indexes for RA diagnosis, combined detection combination of D-dimer and anti-CCP has better value for RA diagnosis.