摘要
目的探讨类风湿关节炎(RA)患者血清淀粉样蛋白A(SAA)、趋化因子配体20(CCL20)及基质金属蛋白酶3(MMP-3)水平变化及临床意义。方法回顾性选取2020年9月至2023年1月大同市第五人民医院收治的RA患者108例作为研究对象,依据28个关节的疾病活动度评分(DAS28)评分,将患者分为缓解期组(n=35,DSA28评分<2.6)与活动期组(n=73,DSA28评分≥2.6),并将活动期患者进一步分为轻度活动期(n=20,DSA28评分2.6~3.2)、中度活动期(n=29,DSA28评分>3.2~5.1)与重度活动期(n=24,DSA28为>5.1);另选取同期健康体检者80名作为对照组。所有受试者均检测血清SAA、CCL20、MMP-3水平。比较不同组别血清SAA、CCL20、MMP-3水平;使用Pearson相关分析血清SAA、CCL20、MMP-3水平与红细胞沉降率(ESR)、C反应蛋白(CRP)的相关性;使用受试者工作特征(ROC)曲线评价各指标对RA疾病活动度的诊断价值。结果RA组血清SAA、CCL20、MMP-3水平分别为(42.25±13.46)mg/L、(45.69±12.78)pg/mL、(85.41±25.14)ng/mL,均显著高于对照组[(7.14±2.12)mg/L、(18.12±5.47)pg/mL、(27.36±8.21)ng/mL],差异均有统计学意义(P<0.05)。RA活动期组患者血清SAA、CCL20、MMP-3水平分别为(51.78±10.71)mg/L、(53.14±10.45)pg/mL、(106.10±20.39)ng/mL,显著高于缓解期组[(22.37±7.14)mg/L、(30.15±8.24)pg/mL、(42.25±13.64)ng/mL],差异均有统计学意义(P<0.05)。重度活动度组血清SAA、CCL20、MMP-3水平均高于中度活动度组和轻度活动度组,差异均有统计学意义(P<0.05),随着疾病活动度提高,血清SAA、CCL20、MMP-3水平逐渐增高。Pearson相关分析显示,活动期RA患者血清SAA、CCL20、MMP-3水平与CRP、ESR均呈正相关(P<0.05)。ROC曲线分析得出,血清SAA、CCL20、MMP-3区分RA轻度活动度与中度活动度的曲线下面积(AUC)分别为0.852、0.756、0.725,区分中度活动度与重度活动度的AUC分别为0.852、0.756、0.725,均显示出一定的诊断能力。结论RA患者血清SAA、CCL20、MMP-3水�
Objective To investigate the changes and clinical significance of serum amyloid A(SAA),chemokine ligand 20(CCL20)and matrix metalloproteinase 3(MMP-3)levels in patients with rheumatoid arthritis(RA).Methods A total of 108 RA patients admitted to the Fifth People's Hospital of Datong City from September 2020 to January 2023 were retrospectively selected as the study subjects.According to the DAS28 score,According to the disease activity score of 28 joints(DAS28)score,the patients were divided into remission group(n=35,DSA28 score<2.6)and active group(n=73,DSA28 score≥2.6),the patients with active stage were further divided into mild active stage(n=20,DSA28 score 2.6-3.2),moderate active stage(n=29,DSA28 score>3.2-5.1)and severe active stage(n=24,DSA28 score>5.1).In addition,80 healthy subjects were selected as the control group.Serum levels of SAA,CCL20 and MMP-3 were detected in all subjects.The levels of serum SAA,CCL20 and MMP-3 in different groups were compared;the correlation between levels of serum SAA,CCL20,MMP-3 and erythrocyte sedimentation rate(ESR)and C-reactive protein(CRP)was analyzed using Pearson correlation;and the diagnostic value of each index for RA disease activity was evaluated by receiver operating characteristic(ROC)curve.Results The levels of serum SAA,CCL20,and MMP-3 in the RA group were(42.25±13.46)mg/L,(45.69±12.78)pg/mL,and(85.41±25.14)ng/mL,respectively,which were significantly higher than those in the control group[(7.14±2.12)mg/L,(18.12±5.47)pg/mL,and(27.36±8.21)ng/mL],and the differences were statistically significant(P<0.05).The levels of serum SAA,CCL20,and MMP-3 in the active group were(51.78±10.71)mg/L,(53.14±10.45)pg/mL,and(106.10±20.39)ng/mL,respectively,which were significantly higher than those in the remission group[(22.37±7.14)mg/L,(30.15±8.24)pg/mL,and(42.25±13.64)ng/mL],and the differences were statistically significant(P<0.05).The levels of serum SAA,CCL20,and MMP-3 in the severe activity group were higher than those in the moderate and mild activity group
作者
霍月红
郭燕羽
王贯虹
HUO Yue-hong;GUO Yan-yu;WANG Guan-hong(Department of Rheumatology and Immunology,the Fifth People's Hospital of Datong City,Datong Shanxi 037000,China)
出处
《临床和实验医学杂志》
2024年第5期497-501,共5页
Journal of Clinical and Experimental Medicine
基金
山西省卫生健康委重点课题(编号:RK25)
大同市科技局平台项目(编号:2018182)。
