血清缺氧诱导因子-1α、Dickkopf-1、抵抗素与痛风性关节炎疼痛、骨破坏的相关性及临床意义  

Relationship between serum HIF-1α,DKK-1,RETN and pain,bone destruction in patients with gouty arthritis and its clinical significance

作　　者：郑戈[1] 毕兵 朱晶 袁一孟[3] ZHENG Ge;BI Bing;ZHU Jing;YUAN Yimeng(Department of Hematoimmunology,Zigong First People's Hospital,Zigong,Sichuan 643000,China;Department of Health Management,Zigong First People's Hospital,Zigong,Sichuan 643000,China;Department of Nephrology,Zigong First People's Hospital,Zigong,Sichuan 643000,China)

机构地区：[1]自贡市第一人民医院血液免疫科,四川自贡643000 [2]自贡市第一人民医院健康管理科,四川自贡643000 [3]自贡市第一人民医院肾病内科,四川自贡643000

出　　处：《安徽医药》2022年第11期2280-2284,共5页Anhui Medical and Pharmaceutical Journal

摘　　要：目的探究痛风性关节炎(GA)病人血清缺氧诱导因子-1α(HIF-1α)、Dickkopf-1(DKK-1)、抵抗素(RETN)与疼痛、骨破坏相关性及临床意义。方法选取自贡市第一人民医院2019年1月至2020年6月106例GA病人,均给予西医常规治疗,治疗后随访3个月,根据是否复发分为复发组(20例)与未复发组(86例),比较两组一般资料、血清HIF-1α、DKK-1、RETN水平、视觉模拟评分法(VAS)、骨破坏指标[血清核因子κβ受体活化因子配体(RANKL)、I型胶原羧基端肽β特殊序列(β-CTX)],分析血清HIF-1α、DKK-1、RETN与VAS评分、骨破坏指标及GA复发的关系,采用受试者工作特征(ROC)曲线评价血清HIF-1α、DKK-1、RETN对GA复发的预测价值。结果复发组VAS评分(7.15±1.49)分、UA(532.66±127.40)μmol/L、血清RANKL(185.26±28.10)ng/L、β-CTX(1.41±0.29)μg/L高于未复发组(P<0.05);复发组血清HIF-1α(53.24±13.15)ng/L、DKK-1(2.92±0.71)μg/L、RETN(30.16±7.04)μg/L高于未复发组(P<0.05);Pearson相关性分析,血清HIF-1α、DKK-1、RETN与VAS评分、RANKL、β-CTX呈正相关(P<0.05);logistic回归分析,调整其他因素后,血清HIF-1α、DKK-1、RETN仍与GA复发显著相关(P<0.05);ROC曲线分析,血清HIF-1α、DKK-1、RETN单独预测GA复发的AUC分别为0.77、0.87、0.82,三者联合预测GA复发的AUC为0.95,95%CI为(0.89,0.99),灵敏度为95.00%,特异度为86.05%,优于各指标单独预测(P<0.05)。结论GA病人血清HIF-1α、DKK-1、RETN与疼痛、骨破坏具有正相关关系,联合检测能为临床预测复发提供新途径。Objective To explore the correlation and clinical significance of serum hypoxia-inducible factor-1α(HIF-1α),Dickkopf-1(DKK-1),resistin(RETN)and pain,bone destruction in patients with gouty arthritis(GA).Methods A total of 106 patients with GA in the First People’s Hospital of Zigong from January 2019 to June 2020 were selected and received conventional Western medicine treatment.The patients were followed up for 3 months after treatment,and they were assigned into recurrence group(20 cases)and non-recurrence group(86 cases)according to whether they recurred.The general data,serum HIF-1α,DKK-1,RETN levels,pain(VAS)score,bone destruction index[serum receptor-activator of nuclear factor kappa B ligand(RANKL),βC-terminal cross-linked telopeptides of typeⅠcollagen(β-CTX)]were compared between the two groups.The relationship between serum HIF-1α,DKK-1,RETN and VAS score,bone destruction index and GA recurrence were analyzed.Receiver operating characteristic(ROC)curve was used to evaluate the effect of serum HIF-1α,DKK-1,RETN on GA recurrence.The receiver operating characteristic(ROC)curve was used to evaluate the predictive value of serum HIF-1α,DKK-1,and RETN on the recurrence of GA.Resultsμmol/L,serum RANKL(185.26±28.10)ng/L,β-CTX(1.41±0.29)μg/L in the recurrence group were higher than those in the non-recurrence group(P<0.05);serum HIF-1α(53.24±13.15)ng/L,DKK-1(2.92±0.71)μg/L,RETN(30.16±7.04)μg/L in the recurrence group were higher than those in the non-relapse group(P<0.05).Pearson correlation analysis showed that serum HIF-1α,DKK-1,RETN and VAS score,RANKL,β-CTX were positively correlated(P<0.05).Logistic regression analysis showed that after adjusting for other factors,serum HIF-1α,DKK-1,RETN were still significantly related to GA recurrence(P<0.05).ROC curve analysis showed that the AUC of serum HIF-1α,DKK-1,RETN alone predicting the recurrence of GA were 0.77,0.87,and 0.82,respectively.The AUC of the three combined prediction of GA recurrence was 0.95,the 95%CI was(0.89,0.99),the sens

关 键 词：关节炎 痛风性 缺氧诱导因子-1Α DICKKOPF-1 抵抗素 

分 类 号：R589.7[医药卫生—内分泌]