原发性舍格伦综合征患者血清MPO-DNA水平与疾病活动度的相关性研究  

Study on the Correlation between Serum MPO-DNA Levels and Disease Activity in Patients with Primary Sj?gren’s Syndrome

作　　者：邓正鑫 刘惠杰 冯长州 周颖 张欢欢 杨晋 DENG Zhengxin;LIU huijie;FENG Changzhou;ZHOU Ying;ZHANG Huanhuan;YANG Jin(Department of Clinical Laboratory,the Affiliated Lianyungang Hospital of Xuzhou Medical University,Jiangsu Lianyungang 222000,China;Rheumatology and Immunology,the Affiliated Lianyungang Hospital of Xuzhou Medical University,Jiangsu Lianyungang 222000,China)

机构地区：[1]徐州医科大学附属连云港医院检验科,江苏连云港222000 [2]徐州医科大学附属连云港医院风湿免疫科,江苏连云港222000

出　　处：《现代检验医学杂志》2024年第5期102-106,共5页Journal of Modern Laboratory Medicine

基　　金：连云港市卫生科技项目(面上课题)(编号:202313)。

摘　　要：目的研究中性粒细胞胞外诱捕网(neutrophil extracellular traps,NETs)在不同疾病活动度的原发性舍格伦综合征(primary Sjögren’s syndrome,pSS)患者外周血中的表达及意义,探究NETs及常规检验指标抗凝血酶(antithrombinⅢ,ATⅢ)、碱性磷酸酶(alkaline phosphatase,ALP)、糖类抗原125(carbohydrate antigen 125,CA125)对pSS疾病活动度的预测价值。方法选取2021年10月~2023年12月徐州医科大学附属连云港医院收治的94例pSS初诊患者,根据欧洲风湿病联盟(European League Against Rheumatism,EULAR)干燥综合征疾病活动指数(Sjögren’s syndrome disease activity index,ESSDAI)分为活动期组(n=49)和非活动期组(n=45)。采用酶联免疫吸附法(ELISA)检测NETs生物标志物即血清髓过氧化物酶(myeloperoxidase,MPO)-DNA复合物水平;将实验室常规指标和MPO-DNA纳入多因素Logistic回归筛选出pSS疾病活动度独立影响因素;Pearson法分析MPO-DNA与ESSDAI评分的相关性;受试者工作特征(ROC)曲线评估MPO-DNA单独或联合ATⅢ,ALP,CA125对pSS疾病活动度的预测价值。结果pSS活动期组患者血清MPO-DNA(23.884±3.494μg/L),ALP(80.159±34.318 U/L),CA125(20.300±16.560 U/ml)水平显著高于非活动期(19.024±3.324μg/L,67.500±21.166 U/L,13.200±6.340 U/ml),ATⅢ活动期(89.180±15.040 ng/ml)低于非活动期(94.650±11.620 ng/ml),差异具有统计学意义(t=-7.921,-2.426,-2.925,2.094,均P<0.05)。多因素Logistic回归分析发现,MPO-DNA,ALP,CA125为pSS疾病活动度独立危险因素,ATⅢ为独立保护因素(均P<0.05);MPO-DNA与ESSDAI评分呈正相关关系(r=0.602,P<0.01)。ALP,CA125,ATⅢ联合预测pSS疾病活动度曲线下面积(95%置信区间)[AUC(95%CI)]为0.711(0.612~0.810),MPO-DNA单独预测AUC(95%CI)为0.837(0.758~0.915),截断值19.869μg/L,MPO-DNA联合ALP,CA125,ATⅢ预测AUC(95%CI)为0.866(0.797~0.935),预测价值得到显著提升。结论NETs参与pSS的疾病发生,表达水平与其疾病活动度有关,NETs联合ALP,CA125,ATⅢ对于pSS的Objective To explore the expression and significance of neutrophil extracellular traps(NETs)in peripheral blood of primary Sjögren’s syndrome(pSS)patients across different disease activity levels,and the predictive value of NETs and routine laboratory markers antithrombinⅢ(ATⅢ),alkaline phosphatase(ALP)and carbohydrate antigen 125(CA125)for pSS disease activity.Methods A total of 94 newly diagnosed pSS patients at the Affiliated Lianyungang Hospital of Xuzhou Medical University from October 2021 to December 2023 were categorized into active(n=49)and non-active(n=45)groups based on the European League Against Rheumatism(EULAR)Sjögren’s Syndrome disease activity index(ESSDAI).The levels of NETs biomarkers,namely serum myeloperoxidase(MPO)-DNA,were measured using ELISA.Laboratory routine indicators and MPODNA were integrated into multivariate Logistic regression to screen for independent influencing factors of pSS disease activity.Pearson’s correlation was used to evaluate the relationship between MPO-DNA levels and ESSDAI scores.The efficacy of MPO-DNA alone or in combination with ATⅢ,ALP and CA125,for predictors of disease activity was evaluated using ROC curve.Results Serum MPO-DNA(23.884±3.494μg/L),ALP(80.159±34.318 U/L)and CA125(20.300±16.560 U/ml)levels of active pSS patients were higher than those in the non-active patients(19.024±3.324μg/L,67.500±21.166U/L,13.200±6.340 U/ml),while ATⅢ(89.180±15.040 ng/ml)was lower than that in non-active patients(94.650±11.620 ng/ml),with significant differences(t=-7.921,-2.426,-2.925,2.094,all P<0.05).Multivariate Logistic regression analysis showed laboratory indicator MPO-DNA,ALP and CA125 were independent risk factors,while ATⅢwas an independent protective factor(all P<0.05).MPO-DNA was positively correlated with ESSDAI scores(r=0.602,P<0.01).The AUC(95%CI)of the combination of ALP,CA125 and ATⅢfor predicting disease activity in pSS was 0.711(0.612~0.810).The AUC(95%CI)of MPO-DNA alone for predicting disease activity in pSS was 0.837(0.758~0

关 键 词：中性粒细胞体外诱捕网 原发性舍格伦综合征 疾病活动度 

分 类 号：R593.2[医药卫生—内科学] R392.11[医药卫生—临床医学]