相关实验室指标在早期类风湿性关节炎中的应用

潘宝龙; 巫玲; 潘丽; 张园园; 李俊娥; 詹学良

Application of Related Laboratory Indexes in Early Rheumatoid Arthritis

Funds:

基金：云南省高层次卫生技术人才专项基金资助项目 (D-201206);

摘要

摘要: 目的评价目前众多类风湿性关节炎 (RA) 相关实验室指标并筛选出最优化的早期RA相关指标.方法设置RA组158例、早期RA组121例、正常对照组100例;检测各组总类风湿因子 (RF) 等14个指标并做统计分析;去除无统计学差别指标, 以ROC曲线评价剩余指标在早期RA中的诊断效能, 以AUC>0.75为标准, 初步筛选出具有诊断效能的指标;将筛出指标做双变量相关分析, 明显相关者归为一类.结果 (1) 14项指标中, 除RF IgA、CRP外, 其余指标在3组中均有明显统计学差异 (P<0.05) ; (2) 单一指标检测曲线下面积 (AUC) 超过0.75的指标6项:GPI (0.929) 、抗MCV (0.923) 、RF IgG (0.904) 、抗CCP (0.901) 、APF (0.891) 和总RF (0.880) ; (3) 经双变量相关分析, 6个指标与是否为早期RA均存在明显正相关, 归集为3类:GPI类、抗MCV类 (含抗CCP和APF) 、RF IgG类 (含总RF) .结论 14项指标中, 仅GPI类、抗MCV类及RF IgG类6项指标对早期RA具有较高诊断效能, 实际工作中每类仅需选择1项开展即可, 临床和实验室应避免重复或开展低效能检测.
- 类风湿性关节炎 /
- 早期诊断 /
- 自身抗体 /
- 诊断效能
Abstract: Objective To evaluate the current related laboratory indicators of rheumatoid arthritis (RA) and screening out the optimal early RA-related indicators.Methods We selected 158 cases as RA group, 121 cases as early RA group, 100 cases as normal control group.The total rheumatoid factor and other 14 indicators were measured and analyzed statistically in each group.No statistical differences indicators were observed, the ROC curve was used to evaluate the diagnostic efficacy of the remaining indicators in early RA, AUC>0.75 as the standard, indicators with diagnostic efficacy were initially screened.The sieve out indicators were used for bivariate correlation analysis, significant correlates are classified as a same class.Results (1) Among the 14 indicators, except for RF IgA and CRP, the other indexes were significantly different in the three groups (P<0.05) .There were 6 indexes which exceeding 0.75 of area under the single index curve (AUC) :GPI (0.929) , anti-MCV (0.923) , RF IgG (0.904) , anti-CCP (0.901) , APF (0.891) and total RF (0.880) ; (3) By bivariate correlation analysis, there was a significant positive correlation between the six indexes and whether they were early RA, and classified as 3 groups:GPI group, anti-MCV group (including anti-CCP and APF) , RF IgG group (including total RF) .Conclusion In the 14 indicators, only 6 indicators (GPI class, anti-MCV class and RF IgG class) have higher diagnostic efficacy for early RA, we only need to choose one to carry out in each category in practice, so as to avoid clinical and laboratory duplication or low-performance testing.
- Rheumatoid arthritis /
- Early diagnosis /
- Autoantibody /
- Diagnostic efficacy

HTML全文

参考文献(15)

[1]	[1]KARLSON E W, SCHAARDENBURG D, HELM-VAN MIL A H, et al.Strategies to predict rheumatoid arthritis development in at-risk populations[J].Rheumatology (Oxford) , 2016, 55 (1) :6-15.
[2]	[2]ALETAHA D, NEOGI T, SILMAN A T, et al.Rheumatoid arthritis classification criteris:an American Collefe of Rheumatology/European League Against Rheumatism collaborative initative[J].Arthritis Rheum, 2010, 62 (9) :2569-2581.
[3]	[3]KANEKO Y, KUWANA M, KAMEDA H, et al.sensitivity and specificity of 2010 rheumatoid arthritis classification criteria[J].Rheumatology (Oxford) , 2011, 50 (7) :1268-1274.
[4]	[4]KATZ P, MARGARETTEN M, TRUPIN L, et al.Role of sleep disturbance, depression, obesity, and physical inactivity in fatigue in rheumatoid arthritis[J].Arthritis Care Res (Hoboken) , 2016, 68 (1) :81-90.
[5]	[5]ARNETT F C, EDWORTHY S, BLOCK D A, et al.The1987 revised ARA criteria for rheumatoid arthritis[J].Arthritis Rheum, 1987, 30 (1) :17-21.
[6]于峰.C反应蛋白与血沉在类风湿性关节炎中的应用价值[J].中国现代药物应用, 2017, 11 (1) :67-68.
[7]盖楠楠, 李国晖.类风湿性关节炎患者血清RF、抗CCP抗体联合检测的临床意义[J].昆明医科大学学报, 2017, 38 (3) :111-114.
[8]	[8]AJEGANOVA S, VAN STEENBERGEN H W, VERHEUL M K, et al.The association between anti-carbamylated protein (anti-Car P) antibodies and radiographic progression in early rheumatoid arthritis:a study exploring replication and the added value to ACPA and rheumatoid factor[J].Ann Rheum Dis, 2017, 76 (1) :112-118.
[9]	[9]SCHELLEKENS, ZHOU W, ZHANG Z L, et al.A comparative study on the diversity of clinical features between the sero-negative and sero-positive rheumatoid arthritis patients[J].Rheumatol Int, 2000, 18 (12) :3897-3901.
[10]	[10]CRISTINA I, ANNA M, LEONOR N, et al.The antigen specificity of the rheumatoid arthritis associated ACPA directed to citrullinated fibrin is very closely restricted[J].Autoimmunity, 2015, 37 (4) :263-272.
[11]梁鹏, 安宏亮, 张劲丰.抗环瓜氨酸肽抗体对类风湿关节炎的诊断及与骨侵蚀相关研究[J].中国卫生检验杂志, 2015, 25 (1) :62-64.
[12]覃仕锋, 李春美.自身抗体检测在自身免疫性疾病中的价值[J].中国免疫学杂志, 2015, 31 (3) :401-403.
[13]	[13]ROY N, TANNER K, MERRILL R M, et al.Descriptive epidemiology of voice disorders in rheumatoid arthritis:prevalence, risk factors, and quality of life burden[J].J Voice, 2016, 30 (1) :74-87.
[14]	[14]LU Q, CUI Y, YE C, et al.Bagging optimal roc curve method for predictive genetic tests, with an application for rheumatoid arthritis[J].J Biopharm Stat, 2010, 20 (2) :401-414.
[15]	[15]HUFFMAN K M, JESSEE R, ANDONIAN B, et al.Molecular alterations in skeletal muscle in rheumatoid arthritis are related to disease activity, physical inactivity, and disability[J].Arthritis Res Ther, 2017, 19 (1) :12-17.

相关文章(20)

[1]	章艳碧, 冯磊, 师瑞, 骆贝贝, 唐灵通, 曹慧颖, 毕千叶. 血液指标在革兰阳性球菌和阴性杆菌感染中的诊疗效能, 昆明医科大学学报. doi: 10.12259/j.issn.2095-610X.S20231218
[2]	李霞, 王晋. 数字乳腺断层摄影（DBT）与全数字化乳腺摄影（FFDM）对乳腺病变诊断效能的对比, 昆明医科大学学报. doi: 10.12259/j.issn.2095-610X.S20220914
[3]	陆健斐, 卜锐, 刘小艳, 张幸, 丁昱, 章然. 常规超声与超声造影对甲状腺乳头状癌患者侧颈区淋巴结转移的术前诊断效能, 昆明医科大学学报. doi: 10.12259/j.issn.2095-610X.S20221214
[4]	李从信, 张大鹏, 沐领捷, 杨吉林, 董丽宏, 王怡洁. HCT-ALB在脓毒症相关性脑病早期诊断中的运用价值, 昆明医科大学学报. doi: 10.12259/j.issn.2095-610X.S20220901
[5]	解琴, 梁艳平, 张引, 徐增辉, 尤丽英. 多种无创诊断模型诊断慢性肝病患者肝纤维化的效能, 昆明医科大学学报. doi: 10.12259/j.issn.2095-610X.S20210719
[6]	梁艳, 高建波, 马俊彦, 杨皓. 高频超声在肢体骨骼肌肉损伤中的诊断效能及影像学特点, 昆明医科大学学报. doi: 10.12259/j.issn.2095-610X.S20211015
[7]	世淑兰, 戴熙廷, 赵广周, 李小娟, 李荣杰, 麻明彪. 16SrRNA基因检测在儿童细菌性脑膜炎早期诊断中的应用, 昆明医科大学学报. doi: 10.12259/j.issn.2095-610X.S20210522
[8]	娄雪, 廖莉, 赵若彤, 王湘宇, 杨一帆, 刘爽, 徐健. 抗dsDNA抗体、补体C3及其他实验室指标对于诊断系统性红斑狼疮肾损伤的临床意义, 昆明医科大学学报. doi: 10.12259/j.issn.2095-610X.S20210214
[9]	余婷婷, 李晓非, 王红英, 张润武, 丁彩梅, 李丽华, 白经, 李冬玲, 普冬. 病毒载量检测在102例HIV抗体不确定样本诊断中的应用, 昆明医科大学学报. doi: 10.12259/j.issn.2095-610X.S20201126
[10]	张颖, 牛小群. 肺泡灌洗液G和GM试验对早期诊断AECOPD患者并发侵袭性肺真菌感染的诊断价值, 昆明医科大学学报. doi: 10.12259/j.issn.2095-610X.S20201217
[11]	吴琪燕, 边革元, 程绘珺, 李娇霞, 王书廷, 黄照略. 肺腺癌预后因素及血清肿瘤标记物的诊断效能, 昆明医科大学学报.
[12]	他林昆, 黄燕玲, 陆永萍. 超声评分法联合增强型血流显示技术在凶险型前置胎盘合并胎盘植入中的应用, 昆明医科大学学报. doi: 10.12259/j.issn.2095-610X.S20201112
[13]	刘明敏, 王丽春, 梁喜, 杨蕊. 超声引导下乳腺微小病变活检应用于乳腺癌早期诊断, 昆明医科大学学报.
[14]	梅茸, 陈文利, 张凤丽, 孟强, 赵忠, 丁里. 脑CT灌注成像在血管性认知功能障碍早期诊断中的应用, 昆明医科大学学报.
[15]	吴晓涛, 李传俊, 伍鑫, 钟世燕. 磁共振成像对强直性脊柱炎早期骶髂关节炎诊断的临床应用价值, 昆明医科大学学报.
[16]	马方伟, 刘敏, 孙燕玲, 赵昊宇, 尹倩, 何惠忠. 血清RF与抗-CCP抗体浓度指标在类风湿关节炎患者诊断和治疗中的临床价值, 昆明医科大学学报.
[17]	潘丽, 潘宝龙, 李俊娥, 吴英松. 类风湿关节炎并发冠心病实验室诊断及相关性, 昆明医科大学学报.
[18]	盖楠楠, 李国晖. 类风湿性关节炎患者血清RF、抗CCP抗体联合检测的临床意义, 昆明医科大学学报.
[19]	徐嵘. 超声检测气管旁淋巴结对自身免疫甲状腺炎的诊断价值, 昆明医科大学学报.
[20]	杨宇舟. 核素显像评价类风湿性关节炎继发干燥综合征的大涎腺功能损害, 昆明医科大学学报.