| Objective:To detect the expression level of Anti-carbamylated protein antibodes(anti-CarP antibody)in serum and synovial fluid of patients with rheumatoid arthritis(RA),investigate the diagnostic value of RA and there relationship with disease activity.Methods:The peripheral blood of 108 patients with RA in the Department of Rheumatology and immunology of the first clinical medical college of Shanxi Medical University from March 2015-2016 were collected,relevant clinical data was recorded;peripheral blood samples were collected from 30 healthy subjects in the same period;the synovial fluid was selected from 31 cases of RA patients and 8 cases of OA patients,joint cavity puncture extraction of the synovial fluid,relevant clinical data was recorded;Enzyme linked immunosorbent assay(ELISA)was used to detect the expression of anti-CarP antibody in serum and synovial fluid;Chi square test,t test,four table method,Kendall,s Tau-b nonparametric analysis,McNemar 2 test,Spearman correlat ion analysis and other methods for statistical analysis.Result:(1)The expression of anti-CarP antibody in serum and synovial fluid of RA was compared with that of control group:serum group:the mean titers of anti-CarP antibody in the RA group and the healthy control group were(3.724±2.104)U/ml,(1.165±0.851)U/ml,the level of anti CarP antibody in serum of RA group was significantly higher than that of healthy control group,the difference was statistically significant(t=5.232,P<0.01).the titer of anti-CarP antibody in group RA was(4.676±1.893)U/ml OA group was(1.971±0.967)U/ml,the difference between the two groups was statistically significant(P<0.01).The expression level of anti-CarP antibody in serum and synovial fluid in RA group was higher than that in control group(O A group and healthy control group).(2)Diagnostic value of anti-CarP antibody in RA:The positive case of anti-CarP antibody in serum of RA group and healthy control group was 50(50/108)and 2(2/30),the anti-CarP antibody for the diagnosis of RA:the s ensitivity,specificity,positive predictive value and negative predictive value were 46.3%,93.3%,96.2% and 32.6%.The positive number of RA and OA synovial fluid was 15(15/31)and 1(1/8),the sensitivity,specificity,positive predictive value and negat ive predictive were 48.4%,87.5%,93.8%,and 30.4%.The anti-CarP antibody in serum and synovial fluid for the diagnosis of RA sensitivity was no statistically significant difference(c2=0.42,P>0.05).(3)Kendall and s Tau-b analysis showed no correlatio n between anti CarP antibody and anti CCP antibody.(4)The 108 patients with RA the anti-CarP antibody positive was 50 cases,the anti-CCP antibody positive was 95 cases,both of antibody were positive was 47 cases,both of both of antibody were negtive was 10 cases,the anti-CCP antibody negtive and the anti-CarP antibody positive was 3(3/13)cases.(5)Correlation analysis of anti-CarP antibody and RA disease activity:the level of anti-CarP antibody was not associated with DAS28 score,ESR,C RP,joint swelling and joint tenderness(r=-0.099;r=-0.070;r=-0.009;r=-0.003;r=-0.071,P<0.05).Conclusion:Anti-CarP antibody was detected in serum and synovial fluid of patients with RA,anti-CarP antibody has a high specificity of 93.1% for the diagnosis of RA,and the sensitivity is less 46.3%.There was no correlation between anti CarP antibody and anti-CCP antibody.The two antibody combined detection can improve the sensitivity of RA diagnosis.It can be used as an effective supplementary diagnosis for anti-CCP antibody negative RA.The expression level was not related to disease activity. |
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