类风湿关节炎患者血清DKK-1,CCL21水平与体液免疫指标的相关性研究  

Study on the Correlation between Serum DKK-1,CCL21 and Humoral Immune Indexes in Patients with Rheumatoid Arthritis

作　　者：刘素芳 赵阳[1] 贾彬[1] 李俊芳[1] LIU Su-fang;ZHAO Yang;JIA Bin;LI Jun-fang(Department of Immunology,the Central Hospital of Handan City,Hebei Handan 056001,China)

机构地区：[1]邯郸市中心医院免疫科,河北邯郸056001

出　　处：《现代检验医学杂志》2022年第3期33-36,52,共5页Journal of Modern Laboratory Medicine

基　　金：河北省医学科学研究课题(20200477);河北省卫生健康委员会资助。

摘　　要：目的探讨类风湿关节炎(rheumatoid arthritis,RA)患者血清Dickkopf-1(DKK-1),趋化因子(chemokine,CCL)21水平与体液免疫指标的相关性。方法选择2018年3月~2020年6月邯郸市中心医院免疫科收治的120例RA患者(RA组)和117例体检志愿者(对照组),根据28个关节疾病活动度(disease activity score 28,DAS28)评分将RA组分为低度组(2.6~3.2分,38例)、中度组(3.3~5.1分,50例)和重度组(>5.1分,32例)。检测血清DKK-1,CCL21,免疫球蛋白A(immunoglobulin A,IgA)、免疫球蛋白G(IgG)、免疫球蛋白M(IgM)、免疫球蛋白E(IgE)、补体C3和补体C4水平。分析DKK-1,CCL21与IgG,IgA,IgM,IgE,补体C3,补体C4之间相关性。结果RA组血清DKK-1(72.14±15.26 pg/ml),CCL21(285.16±32.16 pg/ml),IgG(16.35±4.56 g/L),IgA(3.65±0.52 g/L)和IgM(1.95±0.42 g/L)水平高于对照组(43.26±7.46 pg/ml,170.06±20.41pg/ml,10.35±1.65g/L,2.02±0.24g/L,1.42±0.39g/L),差异均有统计学意义(t=10.061~32.803,均P<0.05),补体C3(1.05±0.16 g/L)和补体C4(0.15±0.07 g/L)水平低于对照组(1.39±0.25g/L,0.36±0.11g/L),差异均有统计学意义(t=12.502,17.579,均P<0.05)。重度组血清DKK-19(83.26±3.09 pg/ml),CCL21(310.06±6.45 pg/ml),IgG(19.84±0.68 g/L),IgA(4.14±0.03 g/L)和IgM(2.28±0.06 g/L)水平高于中度组(74.90±6.59 pg/ml,289.75±12.54 pg/ml,17.40±2.11 g/L,3.71±0.26 g/L,2.03±0.16 g/L)和轻度组(59.15±2.34 pg/ml,258.15±4.06 pg/ml,12.03±0.21 g/L,3.16±0.02 g/L,1.57±0.03 g/L),差异均有统计学意义(t=6.322~162.999,均P<0.05);补体C3和补体C4水平低于中度组(1.18±0.02 g/L vs 1.07±0.05 g/L,0.20±0.01 g/L vs 0.16±0.04 g/L)和轻度组(0.91±0.02 g/L,0.09±0.01 g/L),差异均有统计学意义(t=5.536~45.847,均P<0.05)。中度组血清DKK-1,CCL21,IgG,IgA和IgM水平高于轻度组(t=12.993~17.468,均P<0.05);补体C3和补体C4水平低于轻度组(t=18.607,10.527,均P<0.05),差异均有统计学意义。RA患者血清DKK-1和CCL21水平与IgG,IgA和IgM呈正相关(r=0.742~0.805,均P<0.05),与补体C3和补体C4水平呈负�Objective To investigate the correlation between serum Dickkopf-1(DKK-1),chemokine(CCL21)and humoral immune indexes in patients with rheumatoid arthritis(RA).Methods A total of 120 RA patients(RA group)and 117 physical examination volunteers(control group)admitted to Department of Immunology,the Central Hospital of Handan City from March 2018 to June 2020 were selected.According to DAS28 scores,the RA group was divided into low-grade group(2.6~3.2 points,38 cases)and moderate group(3.3~5.1 points,50 cases)and severe group(>5.1 points,32 cases).Serum levels of DKK-1,CCL21,immunoglobulin A(IgA),immunoglobulin G(IgG),immunoglobulin M(IgM),immunoglobulin E(IgE),complement C3 and complement C4 were detected.The correlation between DKK-1,CCL21 and IgG,IgA,IgM,IgE,complement C3 and complement C4 was analyzed.Results The serum levels of DKK-1(72.14±15.26 pg/ml),CCL21(285.16±32.16 pg/ml),IgG(16.35±4.56 g/L),IgA(3.65±0.52 g/L)and IgM(1.95±0.42 g/L)in RA group were higher than those in control group(43.26±7.46 pg/ml,170.06±20.41pg/ml,10.35±1.65g/L,2.02±0.24g/L,1.42±0.39g/L),the differences were statistically significant(t=10.061~32.803,all P<0.05),and the levels of complement C3(1.05±0.16 g/L)and complement C4(0.15±0.07 g/L)were lower than those in control group(1.39±0.25g/L,0.36±0.11g/L),the differences were statistically significant(t=12.502,17.579,all P<0.05).The serum levels of DKK-19(83.26±3.09 pg/ml),CCL21(310.06±6.45 pg/ml),IgG(19.84±0.68 g/L),IgA(4.14±0.03 g/L)and IgM(2.28±0.06 g/L)in severe group were higher than those in moderate group(74.90±6.59 pg/ml,289.75±12.54 pg/ml,17.40±2.11 g/L,3.71±0.26 g/L,2.03±0.16 g/L)and mild group(59.15±2.34 pg/ml,258.15±4.06 pg/ml,12.03±0.21 g/L,3.16±0.02 g/L,1.57±0.03 g/L),the differences were statistically significant(t=6.322~162.999,all P<0.05),and the levels of complement C3 and complement C4 in severe group were lower than those in moderate group(1.18±0.02 g/L vs 1.07±0.05 g/L,0.20±0.01 g/L vs 0.16±0.04 g/L)and mild group(0.91±0.02 g/L,0.09±0.

关 键 词：类风湿关节炎 DICKKOPF-1 趋化因子 体液免疫 

分 类 号：R593.22[医药卫生—内科学] R392.11[医药卫生—临床医学]