类风湿关节炎患者肌骨超声和外周血超氧化物歧化酶、对氧磷酯酶-1表达特征及其相关性分析  

Expression characteristics and correlation analysis of superoxide dismutase and paraoxophosphatase 1 in peripheral blood and musculoskeletal ultrasound in patients with rheumatoid arthritis

作　　者：刘项坤 陈力 郝振叶 韩慧娟 LIU Xiang-kun;CHEN Li;HAO Zhen-ye(Department of Rheumatology and Immunology,Taiyuan Iron and Steel(Group)Co.,LTD.General Hospital,Taiyuan Shanxi 030008,China;Department of Ultrasound,Taiyuan Iron and Steel(Group)Co.,LTD.General Hospital,Taiyuan Shanxi 030008,China)

机构地区：[1]太原钢铁(集团)有限公司总医院风湿免疫科,山西太原030008 [2]太原钢铁(集团)有限公司总医院超声科,山西太原030008

出　　处：《临床和实验医学杂志》2024年第11期1168-1172,共5页Journal of Clinical and Experimental Medicine

基　　金：山西省医学重点科研项目(编号:2021XM52)。

摘　　要：目的 探究类风湿关节炎患者肌骨超声和外周血超氧化物歧化酶(SOD)、对氧磷酯酶-1(PON-1)表达特征及其相关性。方法 前瞻性选取2019年4月至2022年4月在太原钢铁(集团)有限公司总医院接受治疗的180例类风湿关节炎患者。均行关节检查,根据28个关节疾病活动指数(DAS28)分组,23例为稳定期(DAS28评分<2.6分),45例患者为轻度活动期(DAS28评分2.6~3.2分),51例患者为中度活动期(DAS28评分3.2~5.1分),61例患者为重度活动期(DAS28评分≥5.1分)。稳定期纳入稳定组,轻度和中度活动期纳入轻中度组,重度活动期纳入重度组。比较各组肌骨超声评分、血清SOD、PON-1水平、膝关节活动度、骨代谢指标[Ⅰ型前胶原羧基端前肽(PⅠNP)、骨保护素、碱性磷酸酶(ALP)]水平,并分析DAS28评分、肌骨超声评分与SOD、PON-1水平的相关性。结果 各组间滑膜增生、血流信号、骨侵蚀、关节积液评分及总分比较,差异均有统计学意义(P<0.05),且随着病情严重程度增加,各评分呈增加趋势。各组间SOD、PON-1水平以及关节活动度比较,差异均有统计学意义(P<0.05),且随着病情严重程度增加,SOD、PON-1水平以及关节活动度呈降低趋势。各组间PⅠNP、骨保护素、ALP水平比较,差异均有统计学意义(P<0.05),且随着病情严重程度增加,PⅠNP、骨保护素、ALP水平呈降低趋势。经Pearson相关性分析,患者的DAS28与肌骨超声评分呈正相关(r=0.896,P<0.05),与SOD、PON-1水平呈负相关(r=-0.913、-0.703,P<0.05)。肌骨超声评分与SOD、PON-1水平呈负相关(r=-0.850、-0.592,P<0.05),SOD水平与患者的PON-1水平呈正相关(r=0.643,P<0.05)。结论 类风湿关节炎患者病情越严重,其肌骨超声评分越高,血清SOD、PON-1水平越低,具有显著相关性。血清SOD、PON-1水平可以用于类风湿关节炎疾病活动度的评估。Objective To explore the expression characteristics of superoxide dismutase(SOD)and paraoxophosphonesterase-1(PON-1)in peripheral blood of rheumatoid arthritis patients with musculoskeletal ultrasound and their correlation analysis.Methods A total of 180 patients with rheumatoid arthritis from Taiyuan Iron and Steel(Group)Co.,LTD.General Hospital from April 2019 to April 2022 were prospectively selected.All joint examinations were performed and grouped according to 28 joint disease activity indices(DAS28),23 patients were stable period(DAS 28 score<2.6 points),45 patients were mild active period(DAS 28 score 2.6-3.2 points),51 patients were moderately active period(DAS 28 score 3.2-5.1 points),and 61 patients were severe active period(DAS 28 score≥5.1 points).The stable period was included in the stable group,the mild and moderate activity period was included in the mild to moderate group,and the severe activity period was included in the severe group.The muscle bone ultrasound scores,serum SOD,PON-1 levels,knee joint range of motion,and bone metabolism indicators[typeⅠprocollagen carboxy terminal peptide(PⅠNP),osteoprotegerin,alkaline phosphatase(ALP)]levels among different groups were compared.The correlation of DAS 28 score,muscuosseous ultrasound score,SOD,and PON-1 levels were analyzed.Results The differences in synovial hyperplasia,blood flow signal,bone erosion,joint effusion scores and total scores among the groups were statistically significant(P<0.05),and as the severity of the disease increased,each score showed an increasing trend.The differences in SOD,PON-1 levels,and joint range of motion among the groups were statistically significant(P<0.05),and as the severity of the disease increased,the levels of SOD,PON-1,and joint range of motion showed a decreasing trend.The levels of PⅠNP,osteoprotegerin,and ALP among the groups were statistically significant(P<0.05).As the severity of the disease increased,the levels of PⅠNP,osteoprotegerin,and ALP showed a decreasing trend.According to Pearson

关 键 词：类风湿关节炎 肌骨超声 超氧化物歧化酶 对氧磷脂酶-1 相关性 

分 类 号：R593.22[医药卫生—内科学]