摘要
目的 探讨英夫利昔单抗对强直性脊柱炎（ankylosing spondylitis,AS）患者骨代谢指标的影响,并分析其与AS活动性指标的相关性.方法 选择2012年1至6月江苏省苏北人民医院风湿免疫科门诊及住院确诊为AS且使用英夫利昔单抗治疗患者,使用英夫利昔单抗治疗（治疗期为30周,剂量为3 ～5 mg·kg^-1·次^-1,共使用6次）.治疗前后采用酶联免疫吸附试验法测定血清抗酒石酸酸性磷酸酶异构体（tartrate-resistant acid phosphatase isomer,TRACP）-5b、骨碱性磷酸酶（bone-specific alkaline phosphatase,BALP）、C反应蛋白（C reactive protein,CRP）和红细胞沉降率（erythrocyte sedimentation rate,ESR）水平,计算AS病情活动度评分（ankylosing spondylitis disease activity score,ASDAS）.根据发病年龄、病程、ESR水平、CRP水平、ASDAS-ESR和ASDAS-CRP分组.分析骨代谢指标变化特点及与临床指标的相关性.结果 共纳入30例AS患者,女6例,男24例,平均年龄为（35±12）岁.英夫利昔单抗治疗前,ESR＞ 20 mm/1 h组与ESR≤20 mm/1 h组[（3.25±0.96） U/L vs.（2.05±0.70）U/L]、CRP＞ 10 mg/L组与CRP≤10 mg/L组[（3.21±0.97） U/Lvs.（2.34±0.95） U/L]、ASDAS-ESR＞3.1组与ASDAS-ESR≤3.1组[（3.04±1.06）U/L vs.（2.24±0.80） U/L]、ASDAS-CRP＞ 3.3组与ASDAS-CRP≤3.3组[（3.14±1.02）U/Lvs.（2.13±0.76） U/L]比较,前者TRACP-5b均明显高于后者,差异有统计学意义（均P＜0.05）.30例AS患者经英夫利昔单抗治疗30周后与治疗前相比,ESR[（9.4±6.6）mm/1 hvs.（28.4±24.4） mm/1 h]、CRP[（4.89±3.26） mg/Lvs.（17.05±19.20） mg/L]、ASDAS-ESR [（1.38±0.41）vs.（3.52±0.84）]、ASDAS-CRP [（1.46±0.47）vs.（3.63±0.82）]和TRACP-5b[（2.08±0.77）U/Lvs.（2.77±1.04）U/L]水平均较治疗前降低,差异有统计学意义（均P＜0.05）.结论 AS患者TRACP-5b水平与ESR、CRP、ASDAS呈正相关,提示骨吸收是AS病情活动的临床表现之一;治疗30周后,英夫利昔单抗治疗组�
Objective To detect the serum levels of bone metabolic indices in patients with ankylosing spondytitis （AS） before and after infliximab treatment and analyze the relevance between bone metabolic indices and activity indices of AS.Methods There were many outpatients and hospitalized patients in our department during January to June in 2012,who were diagnosed as AS and were received infliximab treatment.They all were treated with infliximab for 30 weeks and the dose was 3-5 mg · kg^-1 each time,a total of 6 time.The serum levels of tartrate-resistant acid phosphatase isomer （TRACP）-5b and bone-specific alkaline phosphatase （BALP） were detected by enzyme-linked immunosorbent assay （ELISA） method.Meanwhile,ankylosing spondylitis disease activity score （ASDAS）,erythrocyte sedimentation rate （ESR）,and C-reactive protein （CRP） were measured and the relevance between the bone metabolic markers and clinical characteristics in patients with AS was analyzed.Results There were 30 patients fulfilled the inclusion criteria of this study,in which 6 were female and 24 were male.The average age was （35 ± 12） years.They were divided into many groups before they received infliximab treatment：the group with abnormal ESR and normal ESR [（3.25 ±0.96）U/L vs.（2.05 ±0.70）U/L],the group with abnormal CRP and normal CRP [（3.21 ±0.97）U/L vs.（2.34 ±0.95） U/L],the group of ASDAS-ESR 〉3.1 and ASDAS-ESR ≤ 3.1 [（3.04 ± 1.06） U/L vs.（2.24 ±0.80） U/L],the group of ASDAS-CRP 〉3.3 and ASDAS-CRP≤3.3 [（3.14 ± 1.02） U/L vs.（2.13 ± 0.76） U/L].Between the gruop,the levels of TRACP-5b of the former were higher than the latter group in each comparison parameter.The following indicators were changed after infliximab treatment compared with those before treatment：ESR [（9.4 ± 6.6） mm/1 h vs.（28.4 ± 24.4） mm/lh],CRP [（4.89 ±3.26） mg/Lvs.（17.05±19.20）mg/L],ASDAS-ESR [（1.38 ±0.41） vs.（3.52±0.84）],ASDAS-CRP [（1.46±0.47） vs.（3.63±0.82）],TRA
出处
《中华临床免疫和变态反应杂志》
2014年第4期278-282,共5页
Chinese Journal of Allergy & Clinical Immunology
