趋化因子CXCL2在孤立性风湿性多肌痛中的临床意义  

Clinical significance of chemokine CXCL2 in isolated polymyalgia rheumatica

作　　者：钱闺唐 冯丹丹 徐帅 汪筱莞 徐亮[1] QIAN Guitang;FENG Dandan;XU Shuai;WANG Xiaowan;XU Liang(Department of Rheumatology and Immunology,the Frist Affiliated Hospital of Wannan Medical College,Wuhu 241000,China)

机构地区：[1]皖南医学院弋矶山医院风湿免疫科,安徽芜湖241000

出　　处：《安徽医学》2024年第7期811-815,共5页Anhui Medical Journal

基　　金：芜湖市科技局民生项目(编号:2020ms3-4)。

摘　　要：目的研究趋化因子CXCL2在孤立性风湿性多肌痛(PMR)中的临床意义。方法从中国临床试验注册中心数据库(ChiCTR1800019715)选取2019年9月至2020年12月6例初诊且治疗后获得缓解的PMR患者血清、6例初诊未治类风湿性关节炎(RA)患者和6例体检正常者进行趋化因子蛋白组学筛选;另选取2021年3月至2023年6月22例初诊PMR患者(PMR活动组)、18例治疗缓解PMR患者(PMR缓解组)、20例RA患者(RA活动组)和20例体检正常者(对照组),采用酶联免疫吸附法(ELISA)对筛选的CXCL2进行验证,分析其与PMR活动组血沉(ESR)、C反应蛋白(CRP)、PMR活动评分(PMR-AS)的相关性,绘制受试者工作特征(ROC)曲线分析CXCL2在PMR诊断与鉴别诊断中的价值。结果蛋白组学筛选出CXCL2在PMR组中呈显著差异表达。ELISA结果显示,PMR活动组血清CXCL2水平低于PMR缓解组(P=0.039)、RA活动组(P=0.006)和对照组(P=0.041)。PMR活动组患者血清CXCL2水平与ESR(r=0.331,P=0.132)、CRP(r=-0.074,P=0.742)以及PMR-AS(r=-0.148,P=0.512)均无明显相关性。ROC曲线分析表明,CXCL2可用于PMR的诊断(AUC=0.709)以及与RA的鉴别诊断(AUC=0.750)。结论趋化因子CXCL2可用于PMR的诊断,及与RA患者的鉴别诊断。Objective To study the clinical significance of the chemokine CXCL2 in isolated polymyalgia rheumatic(PMR)patients.Methods Serum samples were collected from 6 PMR patients who were selected for chemokine proteomic screening from the Chinese Clini⁃cal Trial Registry(ChiCTR 1800019715)established in our centre.In addition,serum samples were collected from another 22 PMR patients who were first diagnosed,18 patients with PMR after treatment remission,20 rheumatoid arthritis(RA)patients who were first diagnosed and 20 healthy individuals.Eenzyme-linked immunosorbent assay(ELISA)was used to determine the difference in the concentration of CXCL2 in the four groups,and the correlation between serum CXCL2 levels and PMR activity were studied.Results Chemokine proteomics screening showed significant differential expression of CXCL2 in six patients with primary diagnosis of PMR;ELISA validation demonstrated that the me⁃dian serum CXCL2 level in the PMR activity group was significantly lower than that in the PMR remission group(P=0.039),and also signifi⁃cantly lower than that in the RA activity group(P=0.006)and the healthy physical examination group(P=0.041);there was no significant corre⁃lation between serum CXCL2 levels in patients with PMR and activity parameters such as erythrocyte sedimentation rate,C-reactive protein,and polymyalgia rheumatica activity score(all P-values>0.05).ROC analysis showed that CXCL2 might be used in the diagnosis of PMR(AUC=0.709)and in the differential diagnosis with RA(AUC=0.750).Conclusions The chemokine CXCL2 plays a role in the development of PMR and may be used in the differential diagnosis with rheumatoid arthritis.

关 键 词：风湿性多肌痛 趋化因子 CXCL2 

分 类 号：R593.2[医药卫生—内科学]