血清淀粉样蛋白A、血管内皮生长因子与类风湿关节炎相关性研究  

The correlation between serum amyloid A,vascular endothelial growth factor and rheumatoid arthritis

作　　者：袁健生 周念 蔡甜 杜燕娇 贾岩 蒋子裕 YUAN Jian-sheng;ZHOU Nian;CAI Tian;DU Yan-jiao;JIA Yan;JIANG Zi-yu(Department of Laboratory Medicine, Nanhai Hospital, Southern Medical University, Guangdong Province, Foshan City 528200, China)

机构地区：[1]南方医科大学附属南海医院检验科,广东佛山528200

出　　处：《河北医科大学学报》2022年第2期213-217,共5页Journal of Hebei Medical University

基　　金：佛山市卫生和计划生育局医学科研项目(20190284);佛山市卫生健康局医学科研项目(20210373)。

摘　　要：目的探讨类风湿关节炎(rheumatoid arthritis,RA)患者血清淀粉样蛋白A(serum amyloid A,SAA)和血管内皮生长因子(vascular endothelial growth factor,VEGF)的表达水平及其在不同疾病活动RA患者的作用。方法收集我院诊治的RA患者98例及体检健康对照组45例,根据类风湿关节炎病情活动度评分(disease activity score 28,DAS28)将RA患者分为高度活动组43例,中度活动组34例,低缓组(低度活动+疾病缓解)21例,分析各组间SAA和VEGF水平,采用Spearman相关性分析血清SAA和VEGF与临床指标的相关性,采用受试者工作特征(receiver operating characteristic,ROC)曲线分析SAA和VEGF对中高活动度RA患者的诊断价值。结果RA组的SAA表达水平、VEGF表达水平明显高于对照组;随着疾病活动度增加,SAA和VEGF表达水平明显增加趋势,高度活动组的SAA和VEGF表达水平明显高于健康对照组和低中度活动组(P<0.05);Spearman相关性分析,SAA和VEGF表达水平与关节压痛数、关节肿胀数、红细胞沉降率(erythrocyte sedimentation rate,ESR)和DAS28评分呈正相关性(P值均<0.05);ROC曲线显示,SAA和VEGF对中高活动度RA患者有预测价值(P<0.05),其中SAA和VEGF联合诊断对中高活动度RA患者预测价值最高,曲线下面积(area under curve,AUC)为0.871。结论血清SAA和VEGF水平参与RA发病的免疫炎症调节,可作为评估RA疾病活动的潜在生物标志物,有助于RA疾病的监测和评估。Objective To investigate the expression levels of serum amyloid A(SAA)and vascular endothelial growth factor(VEGF)in patients with rheumatoid arthritis(RA)and their roles in different disease activities in RA patients.Methods A total of 98 RA patients treated in our hospital and 45 healthy controls were collected.According to disease activity score 28(DAS28),RA patients were divided into a high activity group(n=43),a moderate activity group(n=34),and a low activity and disease remission group(low activity+disease remission,n=21).Spearman correlation was used to analyze the correlation between serum SAA,VEGF levels and clinical indicators.Receiver operating characteristic(ROC)curve was used to analyze the diagnostic value of SAA and VEGF in patients with moderate to high activity RA.Results The expression levels of SAA and VEGF in RA group were significantly higher than those in control group.With the increase of disease activity,the expression levels of SAA and VEGF were significantly increased.The expression levels of SAA and VEGF in the high activity group were significantly higher than those in the healthy control group and the low-moderate activity group(P<0.05).Spearman correlation analysis showed that the expression levels of SAA and VEGF were positively correlated with the number of joint tenderness,joint swelling,ESR and DAS28 scores(all P<0.05).The ROC curve showed that SAA and VEGF had a predictive value for patients with moderate to high activity RA(P<0.05),and the combined diagnosis of SAA and VEGF had the highest predictive value for patients with moderate to high activity RA,and the area under the ROC curve(AUC)was 0.871.Conclusion Serum SAA and VEGF levels are involved in the immune-inflammatory regulation of RA,which can be used as potential biomarkers to evaluate the activity of RA and contribute to the monitoring and evaluation of RA.

关 键 词：关节炎 类风湿 血清淀粉样蛋白A 血管内皮生长因子类 

分 类 号：R593.22[医药卫生—内科学]