不同疾病分期强直性脊柱炎患者外周血DKK-1、MMP-3、TNF-α和IL-6的表达及治疗前后水平变化  

The expression of DKK-1,MMP-3,TNF-αand IL-6 in peripheral blood of ankylosing spondylitis patients with different disease stages and the changes before and after treatment

作　　者：刘小莉[1] 张红梅[1] 唐敏[1] 张静[1] 邹明[1] 黄玉霞[1] LIU Xiao-li;ZHANG Hong-mei;TANG Min;ZHANG Jing;ZOU Ming;HUANG Yu-xia(Laboratory Department,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：《现代免疫学》2020年第4期300-305,共6页Current Immunology

基　　金：四川省骨科医院院内课题(2017-05)。

摘　　要：为探讨Dickkopf-1(DKK-1)、基质金属蛋白酶3(matrix metalloproteinase 3,MMP-3)、TNF-α和IL-6在强直性脊柱炎(ankylosing spondylitis,AS)患者外周血的表达情况及与疾病分期的相关性和中西医结合治疗前后的变化,选取2017年1月至2018年6月在四川省骨科医院初诊为AS的患者40例(病例组),并选取同期健康体检者40例(对照组)。所有患者随访12周,检测分析基线水平(第0周)、治疗第6周、12周及对照组血清DKK-1、MMP-3、TNF-α和IL-6水平,绘制受试者工作曲线(receiver operating curve,ROC),探讨各项指标在AS患者中的诊断价值。结果显示,患者组DKK-1水平低于对照组,MMP-3、TNF-α和IL-6的表达水平高于对照组,差异有统计学意义(P<0.05);AS早期患者各项指标显著高于晚期患者(P<0.05);患者经治疗后与前一随访点比较,第6周MMP-3、TNF-α和IL-6水平差异有统计学意义(P<0.05),DKK-1水平差异无统计学意义(P>0.05)。AS患者血清DKK-1、MMP-3和TNF-α水平与IL-6水平呈正相关(r值依次为0.388、0.482和0.373,均P<0.05)。根据ROC曲线,DKK-1、MMP-3、TNF-α和IL-6单独检测诊断AS的AUC分别为0.670、0.653、0.818和0.745,灵敏度分别为87.50%、80.00%、47.50%和62.50%,特异度分别为40.00%、47.50%、90.00%和92.50%。四项指标联合诊断AS的AUC为0.881,敏感度和特异度分别为70.00%和87.50%。由此,该4项指标可作为AS患者早期诊断及评判疗效的参考,其联合检测可提高AS诊断的敏感度和特异度。To study the expression of Dickkopf-1(DKK-1),matrix metalloproteinase 3(MMP-3),TNF-αand IL-6 in peripheral blood of patients with ankylosing spondylitis(AS)and its correlation with disease stage and the changes before and after treatment with integrated Chinese and Western medicine,a total of 40 patients who were admitted to Sichuan Provincial Orthopedic Hospital from January 2017 to June 2018 diagnosed with AS(the case group),and 40 healthy subjects were selected(the control group).All AS patients completed 12 weeks of follow-up.The DKK-1,MMP-3,TNF-αand IL-6 levels were measured in basal line(0 week),6 th week,12 th week respectively and the receiver operating curve(ROC)was drawn to investigate the diagnostic value of each index in case group and control group.The results showed that the level of DKK-1 in the AS group was significantly lower than those in the control group,the MMP-3,TNF-αand IL-6 levels were higher than those in the control group(P<0.05).The levels of the 4 indicators in the early AS patients were significantly higher than those in the advanced patients(P<0.05).The levels of MMP-3,TNF-αand IL-6 after treatment of 6 weeks were significantly lower than those in the 0 week(P<0.05)while the levels of DKK-1 showed no significance.Serum IL-6 levels in AS patients were correlated with DKK-1,MMP-3 and TNF-αlevels(r=0.388,0.482,0.373,all P<0.05).According to the ROC curve,the AUC of DKK-1,MMP-3,TNF-α,IL-6 in the diagnosis of AS were 0.670,0.653,0.818,0.745,and the sensitivity were 87.50%,80.00%,47.50%,62.50%,the specificity were 40.00%,47.50%,90.00%,92.50%respectively.The AUC of combined detection of the 4 markers in the diagnosis of AS was 0.881,the sensitivity and specificity were 70.00%and 87.50%.Therefore,these 4 indicators could be a reference for early diagnosis and treatment efficacy for AS patients,whose combined detection could improve the sensitivity and specificity of AS diagnosis.

关 键 词：强直性脊柱炎 DKK-1 MMP-3 TNF-Α IL-6 

分 类 号：R392[医药卫生—免疫学]