目的:分析关节液中抗环瓜氨酸肽(CCP)抗体对类风湿关节炎(RA)的诊断和评估意义。方法:用ELISA法检测37例RA患者血清和关节液中的抗CCP抗体和13例对照组关节炎患者关节液中的抗CCP抗体,并测定类风湿因子(RF),记录RA患者的一些临床参数。对检测结果及临床参数进行统计分析。结果:关节液中抗CCP抗体对RA诊断的敏感度为72.9%,特异度为92.3%。RA组和对照关节炎组患者的关节液中抗CCP抗体的差异有显著性。RA组血清与关节液中抗CCP抗体的浓度高度相关(P<0.001),且关节液中抗CCP抗体与关节液中RF浓度有较高相关性(P<0.01)。RA组关节液中抗CCP抗体与病程相关,病程越长,抗CCP抗体滴度越高;而与肿胀关节数、压痛关节数、疾病活动评分(DAS28)、血清RF、红细胞沉降率(ESR)、C反应蛋白(CRP)和Steinbrocker放射线分级不相关。结论:关节液中抗CCP抗体对RA的诊断有高度特异性和较好敏感性,对其他关节炎有显著性差异,独立于一些临床参数,同时又与血清中抗CCP抗体及关节液中的RF相关。 OBJECTIVE: To analyze the diagnostic and evaluation significance of anti-cyclic citrullinated peptide (CCP) antibody in rheumatoid arthritis on rheumatoid arthritis (RA). Methods: Anti-CCP antibodies in anti-CCP in serum and synovial fluid of 37 RA patients and in arthritis patients in 13 control patients were detected by ELISA, and rheumatoid factor (RF) was measured. Some clinical records of RA patients parameter. The test results and clinical parameters for statistical analysis. Results: The sensitivity of anti-CCP antibody in joint fluid to diagnosis of RA was 72.9% and the specificity was 92.3%. There was a significant difference in anti-CCP antibody in the joint fluid between RA and control arthritis groups. The concentration of anti-CCP antibody in the serum of RA group was significantly correlated with the concentration of anti-CCP antibody in the synovial fluid (P <0.001), and the anti-CCP antibody in synovial fluid had a higher correlation with RF concentration in synovial fluid (P <0.01). The anti-CCP antibody in joint fluid of RA group was associated with the course of disease. The longer the course of disease, the higher the titer of anti-CCP antibody. However, the anti-CCP antibody in joint fluid was significantly correlated with the number of swollen joint, tender joint, disease activity score (DAS28), serum RF, erythrocyte sedimentation rate (ESR) , C-reactive protein (CRP) and Steinbrocker radiation classification was not related. CONCLUSIONS: Anti-CCP antibody in synovial fluid is highly specific and sensitive to the diagnosis of RA and has significant difference to other arthritis. It is independent of some clinical parameters, and at the same time is also associated with anti-CCP in serum and in synovial fluid RF related.