Also Known As
瓜氨酸抗体
抗瓜氨酸抗体
抗环瓜氨酸肽抗体
抗CCP抗体
正式名称
抗环瓜氨酸肽抗体
本文最后审核 时间
本文 最后修改 时间
2018/04/18.
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为何检测?

用于类风湿关节炎(RA)的诊断和与其他类型关节炎进行区分;有时用于评估RA患者预后。

何时检测?

当医生发现患者具有关节炎症和/或未确诊或未分化关节炎症状,提示可能为RA但不满足RA诊断标准时,可申请检测。

何种样本?

采自肘静脉的血液样本。

是否需要做试验前准备?

不需要。

检测什么?

抗环瓜氨酸肽抗体(CCP)检测是检测血液中瓜氨酸抗体一种较新的测定方法。这些自身抗体是瓜氨酸刺激免疫系统产生的蛋白。瓜氨酸是由精氨酸衍生而来的非天然氨基酸。推测精氨酸向瓜氨酸转变可能在类风湿关节炎(RA)关节自身免疫炎症过程中扮演一定角色。

        RA是一种慢性系统性自身免疫性疾病,可导致手、足和其他关节炎症、疼痛、僵直和破坏性改变。目前有多种治疗方法可以有效减少RA并发症引起的损害,但前提是必须在关节显著损伤之前正确诊断。类风湿因子(RF)是用于发现RA,并将其与其他类型关节炎或炎症过程进行区分的重要血液检测项目。但是,RF检测的灵敏度和特异性不够理想。在具有RA临床体征的患者中RF可能为阴性,而在无临床体征的患者中可能为阳性。研究表明CCP检测灵敏度和特异性都高于RF,而且在早期RA中也可检出。

        据美国风湿病学会称,CCP抗体可在50-60%的早期RA中检出,在症状发作后3-6个月即可检出。RA的及时发现和诊断可允许医生采取侵入性的治疗方法,减少相关并发症和组织损伤的发生。

测试样本如何采集?

抽取肘部静脉血。

是否需要进行任何试验前准备以保证样本的质量?

不需要任何试验前准备。

Accordion Title
常见问题
  • 有何用途?

    CCP检测可在类风湿因子(RF)检测之后或同时进行以帮助诊断类风湿关节炎(RA)。CCP也可用于评估未分化关节炎--即具有相应的症状提示RA但不满足美国风湿病学会RA诊断标准的患者进展为RA的可能性。据美国风湿病学会称,大约95%CCP检测阳性患者会发展为RA。

  • 何时检测?

    当患者具有未确诊的炎性关节炎或已诊断为未分化关节炎时可同时申请CCP和RF检测。在患者出现关节疼痛和炎症等临床症状而RF检测结果阴性,医生怀疑RA可能性时也可申请CCP检测。

  • 试验结果的含义?

    一般而言,不能除外临床症状和体征背景,以单一的检测结果进行评估。当RF和CCP均为阳性时,患者发生RA的可能性很大,而且有可能发展为严重的RA。当RF阴性、CCP阳性同时具有提示RA的临床症状时,患者可能为早期RA,或者随后将发展为RA。

            当RF阳性、CCP阴性时,临床症状和体征成为决定患者是否患有RA或其他炎症疾病更重要的因素。当RF和CCP均为阴性时,患者发生RA可能性较小。但必须强调的是,RA是一种临床诊断,在自身抗体检测阴性的情况下也可确诊。

  • 还有什么我需要了解的吗?

    CCP检测具有预测作用,且目前使用范围越来越广泛;但是CCP检测最终的临床价值和最佳使用方式还需进一步完善。

  • 每个人都需要检测CCP吗?

            不是。不推荐对人群进行CCP筛查。同RF一样、CCP检测最好在具有提示RA临床症状的患者或已诊断为未分化关节炎的患者中进行。

参考文献

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Dina Dadabhoy, M.D., University of Michigan, Division of Rheumatology.