Abstract:

Objective To investigate the determinations of human leucocyte antigen（HLA）-DR4,anti-cyclic citrullinated peptide（CCP） antibody and anti-Sa antibody for the diagnosis of rheumatoid arthritis（RA）,and to provide a reference for clinical diagnosis. Methods A total of 148 patients with RA（RA group） and 50 healthy subjects （healthy control group） were enrolled. The levels of HLA-DR4 were determined by sequence specific primer polymerase chain reaction（PCR）,and the levels of anti-CCP antibody and anti-Sa antibody were determined by enzyme-linked immunosorbent assay （ELISA）. Risk factor analysis and the evaluation of combined determinations were performed.Results The positive rates of HLA-DR4, anti-CCP antibody amd anti-Sa antibody in RA group were higher than those in healthy control group, and there were positive correlations of HLA-DR4,anti-CCP antibody and anti-Sa antibody with RA [odds ratios（OR） were 3.28,172.63 and 34.21]. The sensitivities of HLA-DR4,anti-CCP antibody and anti-Sa antibody in RA group were 45.95%,78.38% and 40.54%,and Youden indices were 0.35,0.78 and 0.41,respectively. The Youden indices of the combined determinations of anti-CCP antibody with anti-Sa antibody,HLA-DR4 with anti-CCP antibody and HLA-DR4 with anti-Sa antibody were 0.87,0.74 and 0.54. Conclusions There is a positive correlation of HLA-DR4 with the occurrence and development of RA,and the combined determination of anti-CCP antibody and anti-Sa antibody can improve the diagnosis of RA.

Key words: Human leucocyte antigen-DR4, Anti-cyclic citrullinated peptide antibody, Anti-Sa antibody, Rheumatoid arthritis