摘要
目的探究强直性脊柱炎(AS)患者血清淀粉样蛋白A(SAA)、高迁移族蛋白B1(HMGB1)、肿瘤细胞坏死因子⁃α(TNF⁃α)表达与疾病活动度的相关性,分析上述指标对AS诊断及疾病活动度评估的价值。方法选取2021年1月至2023年10月信阳市中心医院风湿免疫科收治的152例AS患者作为研究组,根据Bath强直脊柱炎病情活动指数(BASDAI)评分分为疾病活动期组与疾病缓解期组。另选取本院80例类风湿关节炎患者作为对照组。比较两组患者血清C反应蛋白(CRP)、SAA、HMGB1、TNF⁃α、红细胞沉降率(ESR)、尿酸(UA),采用Spearman法分析AS患者血清SAA、HMGB1、TNF⁃α水平与疾病活动度的相关性,受试者工作曲线(ROC)分析血清SAA、HMGB1、TNF⁃α单一及联合检测在AS诊断中的应用价值。结果研究组血清UA、CRP、ESR、SAA、HMGB1、TNF⁃α水平均高于对照组,差异具有统计学意义(t=5.827、50.112、50.329、35.944、46.683、67.298,P<0.05)。疾病活动期患者血清SAA、HMGB1、TNF⁃α水平均高于疾病缓解期患者,差异具有统计学意义(t=10.977、13.302、12.705,P<0.05)。Spearman分析显示,AS患者血清SAA、HMGB1、TNF⁃α表达与疾病活动度均正向相关线性关系(r=0.743、0.684、0.571,P<0.005)。ROC曲线显示,血清SAA、HMGB1、TNF⁃α三者联合检测时,预测AS的AUC为0.922,敏感性、特异性分别为92.76%、90.00%,优于单一检测(P<0.05)。结论AS活动期患者血清SAA、HMGB1、TNF⁃α表达明显升高,且SAA、HMGB1、TNF⁃α与AS的疾病活动度具有明显的相关性,三者联合检测可为AS诊断及疾病活动度评估提供重要的参考依据。
Objective To explore the correlation between the expression of serum amyloid A(SAA),high migration group protein B1(HMGB1),tumor cell necrosis factor⁃α(TNF⁃α)and disease activity in patients with ankylosing spondylitis(AS),and analyze the value of these indicators in the diagnosis of AS and the evaluation of disease activity.Methods 152 AS patients admitted to the Rheumatology and Immunology Department of Xinyang Central Hospital from January 2021 to October 2023 were selected as the study group.According to bath ankylosing spondylitis disease activity index(BASDAI)score,the study group was divided into a disease active group and a disease remission group.And 80 patients with rheumatoid arthritis were selected as the control group.Serum C⁃reactive protein(CRP),SAA,HMGB1,TNF⁃α,erythrocyte sedimentation rate(ESR)and uric acid(UA)were compared between the two groups.The correlation between serum levels of SAA,HMGB1,TNF⁃α,and disease activity was analyzed using the Spearman method.The value of single and combined detection of serum SAA,HMGB1,and TNF⁃αin the diagnosis of AS was analyzed using the receiver operating curve(ROC).Results The levels of serum UA,CRP,ESR,SAA,HMGB1,and TNF⁃αin the study group were significantly higher than those in the control group,with statistical significance(t=5.827,50.112,50.329,35.944,46.683,67.298,P<0.05).Serum levels of SAA,HMGB1,and TNF⁃αin patients with the active stage were higher than those in patients with the remission stage,and the difference was statistically significant(t=10.977,13.302,12.705,P<0.05).Spearman analysis showed that the expression of SAA,HMGB1 and TNF⁃αin serum of AS patients were positively correlated with disease activity(r=0.743,0.684,0.571,P<0.005).The ROC curve demonstrated that when serum SAA,HMGB1,and TNF⁃αwere combined,the AUC for predicting AS was 0.922,with a sensitivity of 92.76%and specificity of 90.00%,better than single detection(P<0.05).Conclusion The levels of SAA,HMGB1,and TNF⁃αin the serum of patients with AS act
作者
张洁
乐君
杨甜甜
ZHANG Jie;LE Jun;YANG Tiantian(Department of Rheumatology and Immunology,Xinyang Central Hospital,Xinyang,Henan,China,464000)
出处
《分子诊断与治疗杂志》
2024年第8期1546-1549,1554,共5页
Journal of Molecular Diagnostics and Therapy
基金
河南省科技厅重点项目(202305146)。
