红细胞沉降率、C反应蛋白水平对强直性脊柱炎的疗效及预后的评估作用  

Evaluation of Sedimentation and C-Reactive Protein Level on the Efficacy and Prognosis of Ankylosing Spondylitis

作　　者：李素娟 王新义 高飞 马淑芳 LI Sujuan;WANG Xinyi;GAO Fei;MA Shufang(Department of Neck,Shoulder,Low Back and Leg Pain,Henan Integrative Medicine Hospital,Zhengzhou 450000,China;Department of Surgery,Henan Integrative Medicine Hospital,Zhengzhou 450000,China;Department of Tumor Hematology,Henan Integrative Medicine Hospital,Zhengzhou 450000,China)

机构地区：[1]河南省中西医结合医院颈肩腰腿痛科,河南郑州450000 [2]河南省中西医结合医院外科,河南郑州450000 [3]河南省中西医结合医院肿瘤血液科,河南郑州450000

出　　处：《河南医学研究》2024年第12期2192-2196,共5页Henan Medical Research

基　　金：2019年度河南省中医药科学研究专项课题(2019ZYBJ27)。

摘　　要：目的 探究红细胞沉降率(ESR)、C反应蛋白(CRP)水平对强直性脊柱炎(AS)的疗效及预后的评估作用。方法 从2020年6月至2022年6月在河南省中西医结合医院就诊的AS患者中选取90例作为研究对象,采用巴斯强制性脊柱炎脊柱活动度(BASMI)评分评估治疗前患者腰部僵痛症状的改善情况,并以治疗后BASMI评分为依据,分为转归组和不良组,采用单因素、logistic回归方程分析影响AS患者预后转归的危险因素,明确血清ESR、CRP表达水平与AS患者预后转归的关系;绘制受试者工作特征(ROC)曲线分析血清ESR、CRP检测对AS患者预后转归的预测价值。结果 90例AS患者,治疗后,直性脊柱炎患者BASMI评分、血清ESR、CRP水平较治疗前降低(P<0.05)。转归组年龄、简式疼痛问卷表(MPQ)和类风湿关节炎活动度评分(DAS28)评分、血清类风湿因子(RF)、趋化素(Chemerin)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、ESR、CRP、白细胞计数(WBC)、血小板计数(PLT)、血尿酸(BUA)、基质金属蛋白酶-3(MMP-3)、基质金属蛋白酶-9(MMP-9)、白介素-17(IL-17)、白介素-4(IL-4)、Toll样受体-4(TLR-4)、血清干扰素-γ(IFN-γ)、白细胞介素1β(IL-1β)、饮酒史占比均低于不良组,血清Treg水平高于不良组,病程、晨僵时间短于不良组(P<0.05)。经logistic回归分析,结果显示,病程(长)、DAS28评分(高)、ESR(高)、BUA(高)、RF(高)、CRP(高)是影响AS患者预后转归的危险因素(P<0.05)。绘制ROC曲线分析结果显示,血清ESR、CRP预测AS患者治疗效果的曲线下面积(AUC)分别为0.724、0.697,两者联合检测预测AS患者治疗效果的AUC为0.830,均高于血清ESR、CRP单独检测。结论 AS患者血清中ESR、CRP表达偏高,且两者高表达均是影响AS患者康复的危险因素,可作为客观有效指标,能较准确预测AS患者的病情变化,联合检测应用价值更高。Objective To explore the evaluation role of erythrocyte sedimentation rate(ESR)and C-reactive protein(CRP)levels in the efficacy and prognosis of ankylosing spondylitis(AS).Methods A total of 90 patients with AS admitted to the Henan Integrative Medicine Hospital from June 2020 to June 2022 were selected as research objects.Bath ankylosing spondylitis disease astivity index(BASMI)score was used to evaluate the improvement of symptoms of lumbar stiffness before treatment,and BASMI score was used as the basis.The patients were divided into outcome group and adverse group.Single factor and logistic regression equation were used to analyze the risk factors affecting the recovery of AS patients,and the relationship between the expression levels of serum ESR and CRP and the recovery of AS patients was clarified.Receiver operating characteristic(ROC)curve was drawn to analyze the predictive value of serum ESR and CRP detection for recovery of AS patients.Results After treatment,BASMI score,serum ESR and CRP levels in 90 patients with AS were significantly decreased compared with those before treatment(P<0.05).Age,simple pain questionnaire(MPQ)and disease activity score in 28 joints(DAS28)scores,serum rheumatoid factor(RF),chemerin,interleukin-6(IL-6),tumor necrosis factor-α(TNF-α),ESR,CRP,white blood cell count(WBC),platelet(PLT),blood uric acid(BUA),matrix metallo proteinase-3(MMP-3),matrix metallo proteinase-9(MMP-9),interleukin-17(IL-17),interleukin-4(IL-4),toll-like receptor-4(TLR-4),interferon gamma(IFN-γ),interleukin-1β(IL-1β),and alcohol consumption in the outcome group were all lower than those in the adverse group.The serum Treg level was higher than that of adverse group,the course of disease and morning stiffness time were shorter than those of adverse group(P<0.05).logistic regression analysis showed that disease duration(length),DAS28 score(high),ESR(high),BUA(high),RF(high),CRP(high)were risk factors affecting the recovery of AS patients(P<0.05).ROC curve analysis showed that serum ESR and CRP predict

关 键 词：强直性脊柱炎 子午流注序贯埋线法 腰部僵痛 红细胞沉降率 C反应蛋白 

分 类 号：R593.23[医药卫生—内科学]