血清NSE水平对ax-SpA患者伴发神经病变的诊断价值  

Diagnostic value of serum NSE level for neuropathy in ax-SpA patients

作　　者：张敏敏 张晨 邓子靖 周玮[4] 沈维干[2] 张育[2,3] ZHANG Minmin;ZHANG Chen;DENG Zijing;ZHOU Wei;SHEN Weigan;ZHANG Yu(Department of Rheumatology and Immunology,Wujin Hospital Affiliated to Jiangsu University/Wujin Clinical College of Xuzhou Medical University,Changzhou,Jiangsu 213002,China;Medical College of Yangzhou University,Yangzhou,Jiangsu 225009,China;Department of Rheumatology and Immunology,Affiliated Subei People′s Hospital of Yangzhou University,Yangzhou,Jiangsu 225001,China;Department of Rheumatology and Immunology,Affiliated Hospital of Yangzhou University,Yangzhou,Jiangsu 225000,China)

机构地区：[1]江苏大学附属武进医院/徐州医科大学附属武进临床学院风湿免疫科,江苏常州213002 [2]扬州大学医学院,江苏扬州225009 [3]扬州大学附属苏北人民医院风湿免疫科,江苏扬州225001 [4]扬州大学附属医院风湿免疫科,江苏扬州225000

出　　处：《检验医学与临床》2022年第14期1945-1949,共5页Laboratory Medicine and Clinic

摘　　要：目的探讨血清神经元特异性烯醇化酶(NSE)水平对中轴型脊柱关节炎(ax-SpA)患者伴发神经病变的诊断价值。方法选取2014年1月至2019年3月扬州大学附属苏北人民医院就诊的348例ax-SpA患者为研究对象,分为伴发神经病变组和未伴发神经病变组,比较两组间的临床资料、实验室指标及疾病活动度指标,分析ax-SpA患者伴发神经病变的危险因素,探讨血清NSE水平对ax-SpA患者神经病变的诊断价值。结果ax-SpA神经病变者111例(31.9%),未伴发神经病变者237例(68.1%)。与ax-SpA未伴发神经病变组比较,ax-SpA伴发神经病变组中男性比例、血红蛋白、丙氨酸氨基转移酶、天门冬氨酸氨基转移酶、碱性磷酸酶、免疫球蛋白A和血清NSE水平明显升高,差异有统计学意义(P<0.05)。两组红细胞沉降率(ESR)、C反应蛋白(CRP)、视觉模拟评分法评分、Bath强直性脊柱炎疾病活动指数(BASDAI)、Bath强直性脊柱炎测量指数(BASMI)、强直性脊柱炎疾病活动指数(ASDAS)-ESR和ASDAS-CRP比较,差异无统计学意义(P>0.05)。多因素Logistic回归分析结果显示男性和NSE水平升高是ax-SpA患者伴发神经病变的危险因素(P<0.05)。血清NSE诊断ax-SpA患者伴发神经病变的受试者工作特征曲线下面积为0.727,灵敏度为67.9%,特异度为70.7%。结论血清NSE水平可作为筛查ax-SpA患者是否发生神经病变的参考指标。Objective To investigate the diagnostic value of serum level of neuron specific enolase(NSE)for neuropathy in axial spondyloarthritis(ax-SpA)patients.Methods Totally 348 patients with ax-SpA in Affiliated Subei People′s Hospital of Yangzhou University from January 2014 to March 2019 were selected and divided into ax-SpA with neuropathy group and ax-SpA without neuropathy group.Clinical data,laboratory data and disease activity indexes were compared between the two groups to analyze the risk factors of ax-SpA patients with neuropathy,and to explore the diagnostic value of serum NSE level in ax-SpA patients with neuropathy.Results There were 111 cases(31.9%)in ax-SpA with neuropathy group and 237 cases(68.1%)in ax-SpA without neuropathy group.Compared with ax-SpA without neuropathy group,the proportion of male,hemoglobin,alanine aminotransferase,aspartate aminotransferase,alkaline phosphatase,immunoglobulin A and serum NSE levels in ax-SpA with neuropathy group increased significantly,with statistical significance(P<0.05).There was no significant difference on erythrocyte sedimentation rate(ESR),C-reactive protein(CRP),visual analogue scale,Bath Ankylosing Spondylitis Disease Activity Index(BASDAI),Bath Ankylosing Spondylitis measurement Index(BASMI),Ankylosing Spondylitis Disease Activity Index(ASDAS)-ESR and ASDAS-CRP between the two groups(P>0.05).Multivariate regression analysis showed that male and NSE increased level were risk factors of neuropathy in ax-SpA patients(P<0.05).The area under the receiver operating characteristic curve of serum NSE in diagnosing with neuropathy of ax-SpA patients was 0.727,the sensitivity and specificity were 67.9%and 70.7%respectively.Conclusion Serum NSE level could be used as a reference index for neuropathy in ax-SpA patients.

关 键 词：中轴型脊柱关节炎 神经元特异性烯醇化酶 神经病变 

分 类 号：R593.2[医药卫生—内科学]