基于多种生物学标记物的疾病活动度评分及其在类风湿关节炎中的应用  

Multi-biomarker Disease Activity Score and Its Application in Rheumatoid Arthritis

作　　者：宋志博[1] 张卓莉[1] 

机构地区：[1]北京大学第一医院风湿免疫科,北京100034

出　　处：《中华临床免疫和变态反应杂志》2017年第1期53-56,共4页Chinese Journal of Allergy & Clinical Immunology

摘　　要：近年来,目标治疗策略明显改善了类风湿关节炎(rheumatoid arthritis,RA)患者的预后,因此,监测RA患者的疾病活动度极为重要,对更理想的评估疾病活动度方法的探索始终没有停止。目前已知,细胞因子在RA发病中发挥重要作用,基于细胞因子寻找新的评估疾病活动度的方法,可能会更客观地反映类风湿关节炎的疾病活动度。Michael Centola等从396种生物学标记物中选择了包括表皮生长因子、血管内皮生长因子、瘦素、白细胞介素-6、血清淀粉样蛋白A、C反应蛋白、血管细胞黏附分子-1、基质金属蛋白酶-1、基质金属蛋白酶-3、肿瘤坏死因子受体1、人软骨糖蛋白-39和抵抗素在内的12种生物学标记物,通过权重计算得到评分,用来评价RA疾病活动度,简称多生物学标记疾病活动性(multi-biomarker disease activity,MBDA)评分。目前已有研究表明,MBDA评分与改良28关节MBDA评分(DAS28)-红细胞沉降率、DAS28-C反应蛋白、临床疾病活动指数、美国风湿病学协会/欧洲抗风湿病联盟Boolean缓解标准及健康评估问卷显著相关。同时与传统的评价RA疾病活动度的指标相比,MBDA评分可以更好地预测影像学进展、疾病复发,并且对治疗策略的选择具有一定的指导价值,仍需进一步研究。Recently,the promotion of Treat to Target has significantly improved the outcome of rheumatoid arthritis（RA） patients. Thus it is important to make continuous effort to find a better assessment of disease activity. It is proven that cytokines were largely contribute to the pathogenesis of RA. A new assessment of disease activity in terms of cytokines might be an objective measurement for RA disease activity. Michael Centola et al chose 12 biomarkers,including EGF,VEGF-A,leptin,resistin,IL-6,SAA,CRP,VCAM-1,MMP-1,MMP-3,TNFR1 and YKL-40 from 396 biomarkers,to measure the disease activity,which were called multi-biomarker disease activity（MBDA） score. Some studies revealed that MBDA score was significantly associated with DAS28-ESR,DAS28-CRP,CDAI,SDAI,HAQ and ACR/EULAR Boolean remission standard. Compared with traditional assessment methods,MBDA score is also advanced in disease activity assessment,predicting radiographic outcome and guide the management,however,it needs further study.

关 键 词：关节炎 类风湿 多生物学标记疾病活动性评分 目标治疗 疾病活动度 影像学进展 

分 类 号：R593.22[医药卫生—内科学]