整合素相关蛋白与类风湿关节炎疾病活动及骨破坏相关性研究  

Study on the correlation of integr in associated protein and disease activity and bone destruction in patients with rheumatoid arthritis

作　　者：武雪 史芳[1] 闫秀清[1] 葛风梅 李昭[1] 张秋双 陈瞿 陈琦 王学彬[1] Wu Xue;Shi Fang;Yan Xiuqing;Ge Fengmei;Li Zhao;Zhang Qiushuang;Chen Qu;Chen Qi;Wang Xuebin(Department of Rheumatology and Immunology,Binzhou Medical University Hospital,Shandong 256603,China)

机构地区：[1]滨州医学院附属医院风湿免疫科,滨州256603

出　　处：《中华风湿病学杂志》2022年第9期603-607,共5页Chinese Journal of Rheumatology

基　　金：北京白求恩公益基金会项目(TY180AN)。

摘　　要：目的分析整合素相关蛋白(CD47)在RA患者血清中的表达水平,探讨其与RA疾病活动及骨破坏的相关性。方法收集65例RA患者和25名健康体检者血清及临床资料;通过超声获取RA患者骨破坏七关节超声评分法(US7)评分数值,根据评分分为低、中、高骨侵蚀组。采用ESLIA法检测RA患者和健康体检者血清CD47、血小板反应蛋白-1(TSP-1)及核因子-κB受体活化因子配体(RANKL)水平。统计方法采用t检验、单因素方差分析、非参数秩和检验、Pearson或Spearman相关分析、Logistic回归分析等。结果①RA组和健康对照组血清CD47、TSP-1及RANKL水平差异有统计学意义(P<0.01),RA组各指标水平均高于健康对照组。②在RA患者中,血清CD47与病程(r=0.301,P<0.05)、CRP(r=0.316,P<0.05)、压痛关节数(TJC)(r=0.254,P<0.05)、肿胀关节数(SJC)(r=0.316,P<0.05)、DAS28评分(r=0.255,P<0.05)、RANKL(r=0.252,P<0.05)呈正相关,与其配体TSP-1(r=0.260,P<0.05)呈正相关;TSP-1与CRP(r=0.299,P<0.05)、TJC(r=0.335,P<0.01)、DAS28评分(r=0.315,P<0.05)、RANKL(r=0.305,P<0.05)呈正相关。③病程[OR(95%CI)=1.048(1.033,1.017)]、TSP-1[OR(95%CI)=1.013(1.000,1.026)]为影响RA骨破坏的独立危险因素。结论RA患者血清CD47水平明显高于健康对照组,且与疾病活动及骨破坏相关。CD47可能通过作用其配体TSP-1参与RA骨破坏进程。Objective To analyze the serum levels of integrin-associated proteins(CD47)in patients with rheumatoid arthritis(RA),and to explore its association with disease activity and bone destruction in RA.Methods Serum and clinical data were collected from 65 RA patients and 25 healthy subjects.RA patients were grouped into low,moderate,and high bone erosion groups according to 7-joint ultrasonography score(US7).The levels of serum CD47,thrombospondin-1(TSP-1)and receptor activator of nuclear factor-κB ligand(RANKL)were measured by enzyme-linked immunosorbnent assay(ELISA)in patients with RA and healthy subjects.The statistical analysis was carried out with independent t-test,analysis of variance,nonparametric rank sum test,pearson or Spearman correlation and logistic regression.Results①The Serum levels of CD47,TSP-1,and RANKL were higher in the RA group than in the healthy controls(P<0.01).②In RA patients,serum CD47 level was positively correlated with disease course(r=0.301,P<0.05),C-reactionprotein(CRP)(r=0.316,P<0.05),number of tender joints(TJC)(r=0.254,P<0.05),number of swollen joints(SJC)(r=0.316,P<0.05),disease activity score in 28 joints(DAS28)(r=0.255,P<0.05),RANKL(r=0.252,P<0.05)and TSP-1(r=0.260,P<0.05).Serum TSP-1 level was positively correlated with CRP(r=0.299,P<0.05),TJC(r=0.335,P<0.01),DAS28(r=0.315,P<0.05),RANKL(r=0.305,P<0.05).③The disease course[OR(95%CI)=1.048(1.033,1.017)]and TSP-1[OR(95%CI)=1.013(1.000,1.026)]were independently relevant factors affecting bone destruction.Conclusion CD47 levels is significantly higher in RA patients than in healthy controls,and is associated with disease activity and bone destruction.CD47 may be involved in the bone destruction process of RA by acting on TSP-1.

关 键 词：关节炎 类风湿 整合素相关蛋白 血小板反应蛋白-1 疾病活动 骨破坏 

分 类 号：R593.22[医药卫生—内科学]