摘要
目的探讨磁共振成像(magnetic resonance imaging,MRI)联合血清γ-氨基丁酸受体相关蛋白2(GABA receptorassociated protein like 2,GABARAPL2)、锌指蛋白706(zinc finger protein 706,ZNF706)与BGCN同族体(within BGCNhomolog,WIBG)对早期类风湿关节炎(rheumatoid arthritis,RA)的诊断价值。方法选取2014年9月至2017年9月于本院就诊的260例RA患者为研究对象,根据病程将入选患者分为早期组(167例)和晚期组(93例),随机选取同期于本院体检的100例健康成人纳入对照组。分析RA患者的MRI征象,比较三组研究对象的血清GABARAPL2、ZNF706和WIBG水平,并采用受试者操作特征曲线的曲线下面积(receiver operating characteristic,AUC)评价其诊断价值。结果早期组和晚期组患者的骨质侵蚀、骨髓水肿和滑膜炎的发生率比较差异均无统计学意义(均P >0.05)。早期组患者血清GABARAPL2、WIBG和ZNF706水平均显著高于晚期组和对照组(均P <0.05);晚期组患者血清GABARAPL2、WIBG和ZNF706水平均显著高于对照组(均P <0.05)。在3个MRI征象中,骨髓水肿对早期RA的诊断价值最高,其次是滑膜炎与骨质侵蚀,三者的灵敏度较高,特异度较低,且三征象联合诊断的价值更高(Youden指数= 0.408)。血清WIBG水平对早期RA的诊断价值最高(AUC=0.708),其次是GABARAPL2(AUC=0.683)与ZNF706(AUC=0.662),三者的灵敏度较低,特异度较高,且三因子联合诊断的价值更高(Youden指数=0.495)。MRI联合血清GABARAPL2、ZNF706与WIBG对早期RA的诊断灵敏度、特异度分别为88.0%、68.9%,诊断价值最高(Youden指数=0.569)。结论 MRI联合血清GABARAPL2、ZNF706与WIBG能显著提高RA的早期诊断水平,值得临床推广应用。
Objective To investigate the value of magnetic resonance imaging (MRI) combined with serum GABA receptor associated protein like 2 (GABARAPL2), zinc finger protein 706 (ZNF706) and within BGCN homolog (WIBG) in the diagnosis of early rheumatoid arthritis (RA). Method 260 patients with RA from September 2014 to September 2017 were enrolled the study and they were divided into early group (n = 167) and late group (n = 93) according to the course of the disease. 100 healthy adults received physical examination during the same time were randomly selected as control group. The MRI features of RA patients were analyzed. The serum levels of GABARAPL2, ZNF706 and WIBG were compared among three groups, and the diagnostic value was evaluated by the area under curve (AUC) of receiver operating curve was performed to evaluate the diagnostic value. Result There were no significant differences in the incidences of bone erosion, bone marrow edema and synovitis between early group and late group (all P > 0.05). The serum levels of GABARAPL2, WIBG and ZNF706 in early group were significantly higher than those in late group and control group (all P < 0.05), and the serum levels of GABARAPL2, WIBG and ZNF706 in late group were significantly higher than those in control group (all P < 0.05). Among three MRI signs, bone marrow edema had the highest diagnostic value for early RA, followed by synovitis and bone erosion. The sensitivity of three signs were high, but their specificity were low, and the value of combined diagnosis of three signs was higher (Youden index = 0.408). For serological detection, serum WIBG level was the most valuable in diagnosis of early RA (AUC = 0.708), followed by GABARAPL2 (AUC = 0.683) and ZNF706 (AUC = 0.662). They had low sensitivity and high specificity, and the value in combined diagnosis of three indexes was higher (Youden index = 0.495). The sensitivity and specificity of MRI combined with serum GABARAPL2, ZNF706 and WIBG levels for early RA were 88.0% and 68.9% respectively, and its diagnostic valu
作者
庄利东
陈曦
陈妍文
陈刚
罗军
吴茜
胡冬
ZHUANG LI-dong;CHEN Xi;CHEN Yan-wen;CHEN Gang;LUO Jun;WU Qian(Department of Clinical Laboratory,Mianyang Central Hospital,Sichuan,Mianyang 621000,China)
出处
《中国医学前沿杂志（电子版）》
2019年第10期131-135,共5页
Chinese Journal of the Frontiers of Medical Science(Electronic Version)
基金
四川省卫生和计划生育委员会科研课题（17PJ380）
