脊柱关节炎患者血清中25-(OH)D3,t-PINP,b-CTx水平表达及临床相关性研究  

Expression of 25-(OH)D3,t-PINP,Β-CTx in Serum of Patients with Spinal Arthritis and Its Clinical Correlation

作　　者：刘小莉[1] 张红梅[1] 张静[1] 邹明[1] LIU Xiao-li;ZHANG Hong-mei;ZHANG Jing;ZOU Ming(Department of Clinical Laboratory,Sichuan Provincial Orthopedic Hospital,Chengdu 610041,China)

机构地区：[1]四川省骨科医院检验科,成都610041

出　　处：《现代检验医学杂志》2020年第3期26-30,共5页Journal of Modern Laboratory Medicine

摘　　要：目的探讨脊柱关节炎(SpA)患者血清中25羟基维生素D3[25-(OH)D3]、总I型前胶原氨基端肽(t-PINP)和I型胶原C端肽(β-CTx)的水平及与疾病活动度的相关性、中西医结合治疗前后水平变化。方法选择2018年6月~2019年6月在四川省骨科医院就诊且初次诊断为SpA患者120例作为病例组,其中包括强直性脊柱炎(AS)患者60例、放射学阴性脊柱关节炎(nr-ax SpA)患者30例和外周型SpA患者30例,同时选择40例健康体检者作为对照组,检测血清中25-(OH)D3,t-PINP和β-CTx的水平。根据Bath强直性脊柱炎活动性指数(BASDAI)评分将SpA患者分为疾病活动组(BASDAI>4.0)及非活动组(BASDAI≤4.0),比较病例组与对照组、SpA患者疾病活动组与非活动组25-(OH)D3,t-PINP和β-CTx水平的差异,及随访40例SpA患者治疗前后水平的变化。结果SpA患者25-(OH)D3水平低于对照组,t-PINP和β-CTx水平高于对照组,差异均有统计学意义(t=7.520,4.118,4.128,均P<0.05),而AS,nr-ax SpA,外周型SpA患者之间三个指标的差异无统计学意义(F=0.070~0.236,均P>0.05)。在AS,nr-ax SpA和外周型SpA中,疾病活动组t-PINP,β-CTx高于非活动组,25-(OH)D3水平只有AS组降低(P<0.05),且t-PINP,β-CTx水平与BASDAI评分呈正相关。随访40例SpA患者接受中西医结合治疗3个月后25-(OH)D3水平升高,t-PINP,β-CTx水平降低(P<0.05)。结论SpA患者外周血中存在25-(OH)D3,t-PINP和β-CTx水平的异常表达,在疾病活动期表现得更加明显。检测25-(OH)D3,t-PINP和β-CTx水平对SpA患者疾病活动性及病情监测具有一定的价值。Objective To study the expression of 25 hydroxyvitamin D3[25-(OH)D3],total procollagen type 1 aminoterminal peptide(t-PINP),C-telopeptides of type 1 collagen(β-CTx)in serum of patients with spinal arthritis(SpA),their correlation with disease activity,and the changes before and after treatment.Methods From June 2018 to June 2019,120 patients with SpA were selected as a case group,including 60 patients with ankylosing spondylitis(AS),30 patients with radio-negative spinal arthritis(nr-ax SpA)and 30 patients with peripheral SpA.At the same time,40 healthy subjects were selected as the control group.The levels of 25-(OH)D3,t-PINP andβ-CTx in serum of the control group and the case group were detected.According to the BASDAI score,SpA patients were divided into disease activity group and inactive group,and the difference of those tree markers between the control group and the case group,the SpA patient disease activity group and the inactive group,and the 40 patients with SpA before and after treatment were observed.Results The level of 25-(OH)D3 in SpA patients was significantly lower than that in the control group,while the levels of t-PINP andβ-CTx were significantly increased(t=7.520,4.118,4.128,all P<0.05).However,there was no significant difference between AS,nr-ax SpA and peripheral SpA patients(F=0.070~0.236,all P>0.05).In SpA patients,the level of 25-(OH)D3 in the disease activity group was significantly lower than that in the non-disease activity group,and the levels of t-PINP andβ-CTx were significantly increased(P<0.05).The levels of t-PINP andβ-CTx were positively correlated with BASDAI score.The level of 25-(OH)D3 was significantly increased in SpA patients who were treated 3 months,and the levels of t-PINP andβ-CTx were significantly decreased(P<0.05).Conclusion Abnormal expression of 25-(OH)D3,t-PINP andβ-CTx levels in SpA patients,which is more obvious in the active phase of the disease.Detection of 25-(OH)D3,t-PINP andβ-CTx levels plays an important role in the monitoring of disease activity

关 键 词：脊柱关节炎 25羟基维生素D3 总I型前胶原氨基端肽 I型胶原C端肽 

分 类 号：R681.5[医药卫生—骨科学] R392.11[医药卫生—外科学]