血清葡萄糖-6-磷酸异构酶在类风湿关节炎疾病活动及骨侵蚀中的作用  

Effect of serum glucose-6-phosphate isomerase in disease activity and bone erosion of rheumatoid arthritis

作　　者：陈亚林 张丽卿 张进荣 CHEN Yalin;ZHANG Liqing;ZHANG Jinrong(Shanxi Medical University,Taiyuan 030001,China;Department of Rheumatology,Fenyang Hospital of Shanxi Province,Fenyang 032200,China;Department of Radiology,Fenyang Hospital of Shanxi Province,Fenyang 032200,China)

机构地区：[1]山西医科大学,太原030001 [2]山西省汾阳医院风湿免疫科,032200 [3]山西省汾阳医院放射科,032200

出　　处：《武警医学》2022年第10期834-838,共5页Medical Journal of the Chinese People's Armed Police Force

基　　金：山西省汾阳医院科技攻关项目(202008)

摘　　要：目的 探讨类风湿关节炎(RA)患者血清中葡萄糖-6-磷酸异构酶(GPI)与疾病活动的关系及其在骨侵蚀中的作用。方法 选择2019-08至2021-02在山西省汾阳医院风湿免疫科就诊的RA患者105例,采用酶联免疫吸附法(ELISA)检测血清GPI值,根据GPI滴度分为GPI阳性组和GPI阴性组,比较两组患者临床资料、实验室指标,如关节肿胀数(SJC)、关节压痛数(TJC)、抗环瓜氨酸肽(CCP)抗体、类风湿因子(RF)、红细胞沉降率(ESR)、C-反应蛋白(CRP)等,计算28个关节计数法疾病活动度评分即DAS28评分;同时完善影像学检查,包括双手X线正位片和骨密度,计算Sharp评分。给予所有患者规范治疗并定期随访,在治疗3、6、9、12个月后评估疾病活动度,记录DAS28评分,于治疗1年后复查双手正位片和骨密度。结果 GPI阳性组SJC[5.00(4.00, 6.00)]、TJC[6.00(5.00, 8.75)]、ESR[(58.70±23.40) mm/h]、CRP[21.82(13.55, 31.90) mg/L]、 DAS28评分(5.44±0.69)高于GPI阴性组[4.00(3.00, 5.00)、 5.00(5.00, 7.00)、(48.72±19.87) mm/h、14.37(6.49, 26.56) mg/L、(5.05±0.50)],差异均有统计学意义(P<0.05)。血清GPI水平与SJC(r=0.317,P=0.046)、TJC(r=0.389,P=0.013)、ESR(r=0.331,P=0.037)、CRP(r=0.324,P=0.042)、DAS28评分(r=0.404,P=0.010)呈正相关。治疗3个月后GPI阳性组DAS28评分(3.27±0.68)高于GPI阴性组(3.00±0.58),差异有统计学意义(P<0.05)。两组RA患者治疗前及治疗1年后Sharp评分、骨密度差异均无统计学意义。结论 GPI可作为反映RA疾病活动度的一项指标,可能具有评估预后的作用,对骨侵蚀无预测价值。Objective To investigate the relationship between serum glucose-6-phosphate isomerase(GPI) and disease activity in patients with rheumatoid arthritis(RA) and its role in bone erosion.Methods One hundred and five patients with RA, who were admitted to the Department of Rheumatology, Fenyang Hospital of Shanxi Province from August 2019 to February 2021, were divided into GPI positive group and GPI negative group according to the titer of serum GPI determined by enzyme-linked immunosorbent assay(ELISA). The two groups were compared in the clinical data and laboratory indexes which included swollen joint count(SJC), tender joint count(TJC), anti-cyclic citrullinated peptide(CCP) antibody, rheumatoid factor(RF), erythrocyte sedimentation rate(ESR) and C-reactive protein(CRP), the 28-joint disease activity score(DAS28)was calculated, conventional radiographs of bilateral hands and bone mineral density was performed, and the Sharp score was also calculated. All patients were given standard treatment and followed up regularly, disease activity was assessed after 3, 6, 9 and 12 months’ treatment, DAS28 scores were recorded, and radiological indexes were reviewed after one year’s treatment.Results SJC[5.00(4.00, 6.00)],TJC[6.00(5.00, 8.75)],ESR[(58.70±23.40) mm/h],CRP[21.82(13.55, 31.90) mg/L] and DAS28 score(5.44±0.69) in GPI positive group were higher than GPI negative group[4.00(3.00, 5.00)、5.00(5.00, 7.00)、(48.72±19.87) mm/h、14.37(6.49, 26.56) mg/L、(5.05±0.50)], there were statistically differences(P<0.05). Serum GPI level was positively correlated with SJC(r=0.317, P=0.046),TJC(r=0.389, P=0.013),ESR(r=0.331, P=0.037),CRP(r=0.324, P=0.042) and DAS28 score(r=0.404, P=0.010), DAS28 score in GPI positive group was higher than GPI negative group after 3 months’ treatment[(3.27±0.68) vs.(3.00±0.58)], and the difference was statistically significant(P<0.05). The difference was not statistically significant in Sharp score and bone mineral density between the two groups before and after treatment.Conclusion

关 键 词：类风湿关节炎 葡萄糖-6-磷酸异构酶 疾病活动度 骨侵蚀 

分 类 号：R593.22[医药卫生—内科学]