Application Of Combined Detection Of NLR、Anti-CCP、RF And Anti-RA33 In The Diagnosis Of Rheumatoid Arthritis

Objective : Rheumatoid arthritis(RA)is a chronic progressive connective tissue systemic disease.Its clinical manifestations are early destructive changes of joints,joint swelling and pain,which lead to cartilage destruction,joint space narrowing,chronic invasive arthritis,until late joint deformity,with varying degrees of disability.The disability rate of 5-10 is as high as 60%.At present,rheumatoid factor(RF)and anti-cyclic citrullinated peptide antibody(anti-CCP antibody)are generally included in the serological detection and diagnosis criteria of RA at home and abroad,but now it has been found that the specificity of RF is poor,while the specificity of anti-CCP antibody is high,but the sensitivity is slightly poor.Therefore,both at home and abroad are actively looking for and studying serological markers with high diagnostic efficiency for RA.At present,studies at home and abroad have shown that the ratio of neutrophils to lymphocytes(NLR)as an inflammatory marker is correlated with malignant tumors,cardiovascular and cerebrovascular diseases,nephropathy and even psychiatric diseases,while less research has been done in the field of immune diseases.Anti-CCP antibody,RF,anti-RA33 antibody,C-reactive protein(CRP)and erythrocyte sedimentation rate(ESR)have been used as serological indicators for the diagnosis of RA.The combined detection of these five indicators for the diagnosis of RA has been reported at home and abroad,but the combined detection of these five indicators for the diagnosis of RA has not been reported so far.The purpose of this study was to explore the clinical value of NLR in the diagnosis of RA,the significance and application value of combined detection of anti-CCP antibody,RF,anti-RA33 antibody,CRP and ESR in the diagnosis of RA,the relationship between RF subtypes and their diagnostic value in RA.Methods:(1)The experiment was divided into RA group,non-RA rheumatic immune group and healthy group.The number of neutrophils(NE),lymphocyte(LY),erythrocyte volume distribution width(RDW),CRP,ESR,anti-CCP antibody,RF,anti-RA33 antibody,RF-IgM,RF-IgG,RF-IgA in WBC,lymphocyte(LY),erythrocyte volume distribution width(RDW),NLR and other indicators were detected respectively.The NLR values were calculated by the ratio of NE to LY,andthe NLR values were calculated by SPSS software.Statistical analysis.(2)The positive detection rates of three groups of anti-CCP antibodies,RF,anti-RA33 antibodies,CRP and ESR were analyzed.The diagnostic performance of these five indicators was discussed through parallel test and series of experiments.(3)ROC curve was used to analyze the diagnostic efficacy of RF-IgM,RF-IgG and RF-IgA.The positive rate and diagnostic performance of RF-IgM,RF-IgG and RF-IgA in the diagnosis of RA were analyzed.Results:(1)SPSS software analysis showed that NLR in RA group was significantly higher than that in non-RA group and healthy control group.NLR in RA patients was positively correlated with WBC,NE and CRP,negatively correlated with LY.The AUC value of NLR was 0.738,sensitivity was 60.8%,specificity was 79.1%.The diagnostic efficacy of NLR was worse than that of anti-CCP antibody and RF,but higher than that of anti-RA33 antibody,CRP and ESR.(2)Degree: RF + anti-CCP antibody + anti-RA33 antibody + CRP + ESR is the highest;specificity: RF +anti-CCP antibody is the highest;series of experimental results show that sensitivity:RF + anti-CCP antibody is the highest;specificity: RF + anti-CCP antibody +anti-RA33 antibody + CRP + ESR is the highest.(3)There were significant correlations among RF-IgM,RF-IgG and RF-IgA.They have high diagnostic value.Conclusion :(1)NLR can be used as a new index of inflammatory reaction to diagnose RA and observe its curative effect.(2)The combined detection of anti-CCP antibody+RF+anti-RA33 antibody can improve the sensitivity and specificity of diagnosis of RA,which is suitable for early diagnosis of RA,and is worth popularizing in clinic.Considering the convenience and economic factors,I propose that only anti-CCP antibody+RF+antiRA33 antibody can be used in the joint detection of RA to achieve the ideal diagnostic effect.(3)The diagnostic efficacy of the three RF subtypes for RA was similar,and they all had moderate diagnostic efficacy,worthy of clinical promotion.