RESUMO
Objective To investigate the application of combined detection of three serum markers,anti-cyclic citrullinated peptide antibody (anti-CCP),rheumatoid factor (RF),anti-keratin antibodies (AKA),for the diagnosis of rheumatoid arthritis.Methods This was a prospective study.Serum samples were randomly obtained from 137 RA patients,265 other autoinmmune diease patients,and 111 normal controls.All of the volunteers were outpatients or inpatients of Peking University Third Hospital from January 2011 to September 2013.Levels of AKA,anti-CCP antibody,RF were measured by indirect immunofluorescence,chemiluminescence,and immune turbidimetry,respectively.The values of 3 serum biomarkers and their varied combinations for RA diagnosis were systemically assessed.The results were compared using fourfold table chi-square (x2) test.Results When using one serum marker,anti-CCP had the highest accuracy (80.39％),Youden's index (YI) (0.51),and Kappa (κ) value (0.55) for the diagnosis of RA.While using three serum markers,anti-CCP + (AKA/RF),AKA /(anti-CCP + RF),anti-CCP/(AKA + RF) and (AKA + RF)/(anti-CCP + RF)/(AKA + anti-CCP) had the highest accuracy (80.94,80.94,80.66),YI (0.51,0.51,0.50),and κ value (0.55,0.56,0.54).Conclusion AntiCCP is the vital marker for RA diagnosis.Anti-CCP + (AKA/RF),AKA/(anti-CCP + RF),and (AKA +RF)/(anti-CCP + RF)/(AKA + anti-CCP) are the most ideal combinations for RA diagnosis.
RESUMO
The association of the progress of diabetic nephropathy with the sclerosis of major artery was investigated.Carotid intima-media thickness (CIMT) was positively correlated with urinary albumin and creatinine ratio,and negatively correlated with glomerular filtration rate in diabetes group,suggesting that thickened CIMT may predict the increasing risk of clinical nephropathy in the patients with microalbuminuria.