中轴型脊柱关节炎血清Dickkopf-1表达及相关性分析  

作　　者：崔银风 张莉芸[2] 张改连[2] 许珂[2] 马丹[2] 郭东强 闫俊荣 

机构地区：[1]山西医科大学,山西030001 [2]山西医学科学院山西大医院风湿免疫科 [3]山西大医院放射科 [4]山西大医院磁共振室

出　　处：《当代医学》2015年第5期8-11,共4页Contemporary Medicine

摘　　要：目的通过检测中轴型脊柱关节炎(ax-Sp A)患者血清Dickkopf-1(DKK-1)水平,并进行相关性分析。方法 (1)采用酶联免疫吸附法(ELISA)检测71例初次就诊ax-Sp A患者[其中51例强直性脊柱炎(AS)和20例非放射中轴型脊柱关节炎(nr-ax Sp A)]、疾病对照组34例(其中14例类风湿关节炎、10例骨关节炎和10例痛风患者)和15例健康人,分别检测血清DKK-1水平;(2)根据HLA-B27表达情况,将ax-Sp A患者分为阳性组(48例)和阴性组(23例);按照修订纽约放射学骶髂关节炎分级标准,AS患者分为Ⅱ级(16例)、Ⅲ级(12例)和Ⅳ级(23例),比较不同分组血清DKK-1的表达差异;(3)分析血清DKK-1水平与ax-Sp A患者临床指标、炎性指标及影像学评分的相关性。结果 (1)AS患者血清DKK-1水平[(2133.9±432.9)ng/L]高于疾病对照组(RA、OA和Gout患者)和健康人[(1718.7±260.4)ng/L],差异有统计学意义(P<0.05)。而低于nr-ax Sp A患者[(2303.9±289.4)ng/L],差异无统计学意义。(2)ax-Sp A患者HLA-B27阳性血清DKK-1水平[(2150.47±440.9)ng/L]低于HLA-B27阴性患者[(2418.8±319.5)ng/L],差异有统计学意义(P<0.05)。AS患者放射学骶髂关节炎Ⅳ级血清DKK-1水平[(1878.91±285)ng/L]低于Ⅱ级[(2248.18±365.53)ng/L],差异有统计学意义(P<0.05),而Ⅲ级血清DKK-1水平分别与Ⅱ级[(2248.18±365.53)ng/L]、Ⅳ级[(1878.91±285)ng/L]比较,差异无统计学意义。(3)血清DKK-1水平与ax-Sp A患者病程(r=-0.424,P=0.0001)、BASMI(r=-0.264,P=-0.026)和AS患者m SASSS评分(r=-0.581,P=0.023)呈负相关,而与ax-Sp A患者临床指标、炎性指标及SPARCC评分无相关性。结论血清DKK-1水平随着渐进骨化程度的加重呈下降趋势,可能是AS发生关节强直和骨赘形成的一个重要因素;血清DKK-1水平可以作为评价AS骨化程度的潜在生物学标志物之一。Objective To detect serum levels of DKK-l（Dickkopf-1） in axial spondyloarthropathy （ax-SpA） and correlation analysis. Methods （1） Enzyme-linked immunosorbent assay （ELISA） was used to detect 71 cases of patients with initial visiting ax-SpA [including 51 cases of ankylosing spondylitis （AS） and 20 cases of non- radiology axial spondyloarthropathy （nr-axSpA）] and serum levels of DKK-I in disease control groups （14 cases of RA, 10 patients of OA and 10 cases of gout patients） and 15 cases of healthy control group; （2）According to the expression of HLA-B27,ax- SpA patients were divided into positive group （48 cases） and negative group （23 cases）;accordance with the revised New York radiological sacroiliitis grading standards,ax-SpA patients were divided into grade Ⅱ （16 cases）, grade Ⅲ （12 cases） and grade Ⅳ （23 cases）, comparing to expression differences of serum DKK-1 in different groups; （3）Correlation analysis serum levels of DKK-1 with ax-SpA patients clinical indicators,inflammatory markers and radiographic score. Results （1）Serum levels of DKK-1 in AS patients [（2133.9±432.9）ng/L] higher than disease control groups （including RA, OA and Gout patients） and healthy control group [（1718.7±260.4）ng/L],it has a statistical significance （P〈0.05）. But lower than nr- axSpA patients [（2303.9＋289.4）ng/L], the difference was not statistically significant. （2）Serum DKK-1 levels in ax-SpA patients with HLA-B27 positive below HLA-B27 negative patients [（2150.47±440.9）ng/L], the difference had a statistically significant （P〈0.05）. Serum levels of DKK- 1 in radiographic sacroiliitis grade Ⅳ patients [（1878.91±285）ng/L] and grade Ⅲ patients [（2059.33±324.26）ng/L], the difference had a statistically significant （P〈0.05）, whereas serum levels of DKK-1 with grade Ⅱ [（2248.18±365.53）ng/L] and Ⅲ grade [（2248.18±365.53）ng/L], grade El and grade IV, differences was no statistically significant.

关 键 词：强直性脊柱炎 中轴型脊柱关节炎 DICKKOPF-1 骶髂关节X线 骶髂关节磁共振成像 

分 类 号：R684.3[医药卫生—骨科学]