类风湿性关节炎患者血清MBL MASP-2和DKK-1水平变化与患者预后相关性  

Changes of Serum MBL Masp-2 and DKK-1 Levels in Patients with Rheumatoid Arthritis and Their Correlation with Prognosis

作　　者：臧雪莲[1] 鞠延玲[1] 赵旭[1] ZANG Xuelian;JU Yanling;ZHAO Xu(Jinzhou Central Hospital,Liaoning Jinzhou 121000,China)

机构地区：[1]辽宁省锦州市中心医院风湿免疫科,辽宁锦州121000

出　　处：《河北医学》2021年第7期1070-1075,共6页Hebei Medicine

基　　金：辽宁省自然科学基金,(编号:20180550906)。

摘　　要：目的:研究类风湿性关节炎(RA)患者血清甘露糖结合凝集素(MBL)、MBL相关的丝氨酸蛋白酶-2(MASP-2)和Dickkopf-1蛋白(DKK-1)水平变化及其与患者预后相关性。方法:选取2017年8月至2020年8月我院194例RA患者和102例健康体检者分别为研究组和对照组,检测入院时血清MBL、MASP-2和DKK-1水平,同时根据28个关节疾病活动评分(DAS28)将患者分为轻度组83例、中度组62例和重度组49例,按指南对RA患者给予达标治疗并根据疗效将患者分为达标组129例和未达标组65例,比较各组血清MBL、MASP-2和DKK-1水平,同时分析其对DAS28评分的影响和对疗效的预测价值。结果:研究组血清MBL和MASP-2水平低于对照组,血清DKK-1水平高于对照组;轻度组、中度组和重度组血清MBL和MASP-2逐渐降低,血清DKK-1水平和DAS28评分逐渐升高;达标组血清MBL和MASP-2水平高于未达标组,血清DKK-1水平低于未达标组,差异有统计学意义(P<0.05)。多元线性回归分析显示,血清MBL和MASP-2水平为影响DAS28评分的重要因素(P<0.05)。血清MBL和MASP-2水平与RA治疗效果存在密切联系,RA治疗未达标的logistics回归模型为Y=12.573-0.722×血清MBL-0.090×血清MASP-2+0.792×血清DKK-1。血清MBL、MASP-2、DKK-1及三者联合检测预测RA疗效的AUC分别为0.896、0.825、0.693和0.958,敏感度分别为72.09%、67.44%、80.62%和89.15%,特异度分别为90.77%、81.54%、52.31%和90.77%。结论:RA患者血清MBL和MASP-2水平明显降低,血清DKK-1水平明显升高,且与病情变化密切相关,可为评估疗效和预后提供参考。Objective:To study the changes of levels of serum mannose-binding lectin(MBL),MBL-associated serine protease-2(MASP-2)and Dickkopf-1 protein(DKK-1)in patients with rheumatoid arthritis(RA)and their correlation with prognosis of patients.Methods:194 RA patients and 102 health examiners in our hospital from August 2017 to August 2020 were selected as the study group and the control group.Serum MBL,masp-2 and DKK-1 levels were detected at admission.According to 28 joint disease activity scores(DAS28),the patients were divided into mild group(n=83),moderate group(n=62)and severe group(n=49).According to the guidelines,RA patients were given standard treatment.According to the efficacy,the patients were divided into standard group(n=129)and standard group(n=65),The serum levels of MBL,masp-2 and DKK-1 were compared in each group,and their influence on DAS28 score and predictive value for curative effect were analyzed.Results:The levels of serum MBL and MASP-2 in study group were lower than those in control group,while the level of serum DKK-1 was higher than that in control group.The levels of serum MBL and MASP-2 in mild,moderate and severe groups were gradually decreased,while the level of serum DKK-1 and DAS28 score were gradually increased.The levels of serum MBL and MASP-2 in standard group were higher than those in non-standard group,while the level of serum DKK-1 was lower than that in non-standard group(P<0.05).Multivariate linear regression analysis showed that the levels of serum MBL and MASP-2 were important factors affecting the DAS28 score(P<0.05).Serum MBL and MASP-2 levels were closely related to the treatment effect of RA,and logistics regression model of substandard RA treatment was shown as Y=12.573-0.722×serum MBL-0.090×serum MASP-2+0.792×serum DKK-1.The AUC values of serum MBL,MASP-2,DKK-1 and the combined detection of the three in predicting the efficacy of RA were 0.896,0.825,0.693 and 0.958 respectively,and the sensitivities were 72.09%,67.44%,80.62%and 89.15%,and the specificities were 90.77

关 键 词：类风湿性关节炎 甘露糖结合凝集素 MBL相关的丝氨酸蛋白酶-2 Dickkopf-1蛋白 

分 类 号：R593.22[医药卫生—内科学]